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日本版患者减药认知简表的开发。

Development of a Japanese version of the patient perceptions of deprescribing - Short form.

作者信息

Kushibuchi Mio, Ie Kenya, Takahashi Masaki, Linsky Amy M, Albert Steven M

机构信息

Faculty of Public Health & Policy London School of Hygiene & Tropical Medicine London UK.

Department of General Internal Medicine St. Marianna University School of Medicine Kawasaki-shi Kanagawa Japan.

出版信息

J Gen Fam Med. 2024 Oct 6;26(1):45-53. doi: 10.1002/jgf2.733. eCollection 2025 Jan.

Abstract

BACKGROUND

Deprescribing is a critical component of clinical practice, especially in geriatric medicine. Nevertheless, the attributes of patients who are prepared for, interested in, and could potentially benefit from deprescribing have not been well examined. The Patient Perceptions of Deprescribing (PPoD) evaluates patients' overall readiness for deprescribing and is complemented by an 11-item validated short form (SF-PPoD). The objective of this study was to develop a Japanese version of the SF-PPoD and assess its reliability and validity within Japanese older adults with polypharmacy.

METHODS

The SF-PPoD was translated, back-translated, and assessed in a cognitive interview. We conducted a cross-sectional survey with 196 patients aged 65 years or older with five or more medications using the Japanese version to test for reliability and validity. We examined internal consistency and construct validity to determine if the Japanese sample responses reproduce the two subscales in the original SF-PPoD. Finally, we examined intra-person replicability using the intraclass correlation coefficient, in which 100 participants were invited and 93 participated.

RESULTS

118 males and 78 females, with a mean age of 79.2 [SD 6.5] years, completed the survey. Confirmatory factor analysis of the Japanese version of SF-PPoD revealed satisfactory structural validity with two-dimensional structure, "Motivation for Deprescribing" and "Primary Care Physician Relationship." Cronbach's alpha showed good internal consistency, and test-retest demonstrated acceptable intra-rater reliability.

CONCLUSIONS

We developed and validated a Japanese version of SF-PPoD with an 11-item, two-dimensional structure consistent with the original SF-PPoD. This scale may facilitate shared decision-making for medication optimization among older adults living with multimorbidity.

摘要

背景

减药是临床实践的关键组成部分,尤其在老年医学中。然而,对于那些准备好、有兴趣且可能从减药中获益的患者的特征,尚未得到充分研究。患者减药认知(PPoD)评估患者对减药的总体准备情况,并辅以一个经过验证的11项简表(SF-PPoD)。本研究的目的是开发SF-PPoD的日语版本,并在日本患有多种药物治疗的老年人中评估其信效度。

方法

对SF-PPoD进行翻译、回译,并在认知访谈中进行评估。我们使用日语版本对196名65岁及以上服用五种或更多药物的患者进行了横断面调查,以测试其信效度。我们检查了内部一致性和结构效度,以确定日本样本的回答是否能重现原始SF-PPoD中的两个子量表。最后,我们使用组内相关系数检查了个体内可重复性,邀请了100名参与者,93人参与。

结果

118名男性和78名女性完成了调查,平均年龄为79.2[标准差6.5]岁。对SF-PPoD日语版本的验证性因素分析显示,具有“减药动机”和“初级保健医生关系”二维结构的结构效度良好。克朗巴哈系数显示出良好的内部一致性,重测显示出可接受的评分者内信度。

结论

我们开发并验证了一个日语版本的SF-PPoD,其11项二维结构与原始SF-PPoD一致。该量表可能有助于患有多种疾病的老年人在药物优化方面进行共同决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10fa/11702458/c831d4859ca4/JGF2-26-45-g002.jpg

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