Adaptation and validation of the revised Patients' Attitudes towards Deprescribing (rPATD) questionnaire for benzodiazepine receptor agonists

Catherine Pétein; Anne Spinewine; Marie-Laure Laroche; Anne Niquille; Séverine Henrard

doi:10.1016/j.sapharm.2023.05.010

Adaptation and validation of the revised Patients' Attitudes towards Deprescribing (rPATD) questionnaire for benzodiazepine receptor agonists

Res Social Adm Pharm. 2023 Sep;19(9):1278-1285. doi: 10.1016/j.sapharm.2023.05.010. Epub 2023 Jun 8.

Authors

Catherine Pétein¹, Anne Spinewine², Marie-Laure Laroche³, Anne Niquille⁴, Séverine Henrard⁵

Affiliations

¹ Clinical Pharmacy research group, Louvain Drug Research Institute, Université catholique de Louvain, Avenue Emmanuel Mounier 72, 1200, Brussels, Belgium. Electronic address: catherine.petein@uclouvain.be.
² Clinical Pharmacy research group, Louvain Drug Research Institute, Université catholique de Louvain, Avenue Emmanuel Mounier 72, 1200, Brussels, Belgium; Pharmacy Department, Université Catholique de Louvain, CHU UCL Namur, Rue Dr Gaston Therasse 1, 5530, Yvoir, Belgium. Electronic address: anne.spinewine@uclouvain.be.
³ Centre of Pharmacovigilance and Pharmacoepidemiology, Department of Pharmacology-Toxicology and Centre of Pharmacovigilance, University Hospital of Limoges, 2 Avenue Martin Luther King, 87042, Limoges Cedex Limoges, France; UR 24134 Vie-Santé, Faculty of Medicine, University of Limoges, Campus Marcland, 2 Rue du Docteur Marcland, 87025, Limoges, France. Electronic address: marie-laure.laroche@chu-limoges.fr.
⁴ Center for Primary Care and Public Health (Unisanté), University of Lausanne, Rue du Bugnon 44, 1011, Lausanne, Switzerland; Community Pharmacy, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, 30 Quai Ernest-Ansermet, CH-1211, Geneva 4, Switzerland. Electronic address: anne.niquille@unisante.ch.
⁵ Clinical Pharmacy research group, Louvain Drug Research Institute, Université catholique de Louvain, Avenue Emmanuel Mounier 72, 1200, Brussels, Belgium; Institute of Health and Society (IRSS), Université Catholique de Louvain, Clos Chapelle-aux-Champs 30, 1200, Brussels, Belgium. Electronic address: severine.henrard@uclouvain.be.

PMID: 37301641
DOI: 10.1016/j.sapharm.2023.05.010

Abstract

Background: The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire explores older adults' views on deprescribing in general. Those views may differ, however, when the target is a specific drug such as benzodiazepine receptor agonists (BZRA).

Objective: This study aimed to adapt the 22-item French rPATD questionnaire to create a BZRA-specific instrument and to assess the psychometric properties of this new tool.

Methods: The adaptation of the questionnaire comprised 3 steps: 1) item transformation during group discussions with 8 healthcare providers and 8 BZRA users (aged ≥65 years), 2) pre-test of the questionnaire with 12 other older adults to ensure items understanding, 3) evaluation of the psychometric properties of the new questionnaire with 221 older BZRA users recruited in Belgium, France, and Switzerland. Construct validity was assessed using exploratory factor analysis (EFA), internal consistency with Cronbach's alpha, and test-retest reliability with intraclass correlation coefficient (ICC).

Results: After the pre-test, the questionnaire had 24 items (19 adapted from the French rPATD, 3 removed, and 5 added). The EFA, however, found that several items performed poorly. Eleven items were consequently removed, based on statistical performance and clinical relevance. Three factors were extracted from the EFA performed on the 11 retained items and were named "Concerns about stopping BZRA", "BZRA inappropriateness", and "Dependence on BZRA". The questionnaire also includes two global questions about willingness to reduce BZRA dosage and willingness to discontinue BZRA. All factors showed acceptable internal consistency (0.68 ≤ Cronbach's alpha ≤0.74). Two factors showed acceptable test-retest reliability. The "Concerns about stopping BZRA" factor was found to vary over time (ICC [95%CI]: 0.35[-0.02; 0.64]).

Conclusions: We developed and validated a 13-item questionnaire to evaluate the attitudes of older people towards BZRA deprescribing. Despite some limitations, this questionnaire appears to be a useful tool for facilitating shared decision-making on BZRA deprescribing.

Keywords: Benzodiazepine receptor agonists; Deprescribing; Older adults; Psychometric properties; Questionnaire adaptation; rPATD questionnaire.

MeSH terms

Aged
Attitude
Deprescriptions*
Humans
Psychometrics
Receptors, GABA-A*
Reproducibility of Results
Surveys and Questionnaires

Substances

Receptors, GABA-A