Validation and Psychometric Properties of the Arabic Version of the Duke Anticoagulation Satisfaction Scale (DASS)

Maha AlAmmari; Khizra Sultana; Sattam Nawaf AlHarbi; Ashwag Saud Marenga; Abdulrahman AlTuraiki; Abdullah Uthman Althemery; Abdullah Ali Alfaifi; Asma AlShehri; Bander Fahad Aqeel

doi:10.3389/fphar.2020.587489

Validation and Psychometric Properties of the Arabic Version of the Duke Anticoagulation Satisfaction Scale (DASS)

Front Pharmacol. 2020 Dec 17:11:587489. doi: 10.3389/fphar.2020.587489. eCollection 2020.

Authors

Maha AlAmmari¹, Khizra Sultana², Sattam Nawaf AlHarbi¹, Ashwag Saud Marenga¹, Abdulrahman AlTuraiki¹, Abdullah Uthman Althemery³, Abdullah Ali Alfaifi³, Asma AlShehri¹, Bander Fahad Aqeel¹

Affiliations

¹ Pharmaceutical Care Services, Ministry of National Guard Health Affairs (MNGHA), King Abdullah international Medical Research Centre (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia.
² Research Office, King Abdullah International Medical Research Centers (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi Arabia.
³ Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdul Aziz University, Al Kharj, Saudi Arabia.

Abstract

Background: To assess the health-related quality of life (HRQoL) of oral anticoagulant therapy users, different types of instruments are available, either general or specific tools like Duke Anticoagulation Satisfaction Scale (DASS). These tools allow the clinician to adjust the treatment regimen to focus on increasing anticoagulation adherence and reduce adverse clinical outcomes. This study aims to validate the translated Arabic version of DASS to assess the satisfaction level of patients using oral anticoagulants in the Arab population. Methods: The Duke Anticoagulation satisfaction scale (DASS) was translated into the Arabic language using MAPI group services. DASS was administered to 505 patients receiving anticoagulation with warfarin or apixaban. The generic scale measuring the quality of life EQ-5D-5L was also administered. Psychometric properties were assessed by Confirmatory Factor Analysis, internal consistency (Cronbach's Alpha), exploratory factor analysis, convergent and divergent validity, and the correlation between the DASS and demographic variables, clinical characteristics, and the EQ-5D-5L instrument. Results: 439 subjects answered all the questions. From a total of 25 items, 22 grouped into three factors (limitations, positive impact, and negative impact). Each factor had good internal consistency (Cronbach Alpha 0.78-0.88). All the three factors correlated consistently with EQ-5D-5L measuring generic quality of life. Conclusion: The psychometric properties of the Arabic DASS version were comparable to the original English version. The Arabic version of the DASS showed very good reliability and validity. It can be used by health care professionals in other settings of anticoagulation clinics to assess patient's satisfaction and limitations to anticoagulant treatment.

Keywords: Duke anticoagulation satisfaction scale; anticoagulation; apixaban; psychometric; quality of life; questionnaire; survey; warfarin.