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Evin A, Bourdon M, Nizet P, Hardouin JB, Victorri-Vigneau C, Huon JF. DEprescribing: Perceptions of PAtients living with advanced cancer. A multicentre, prospective mixed observational study protocol. PLoS One 2024; 19:e0305737. [PMID: 39163415 PMCID: PMC11335145 DOI: 10.1371/journal.pone.0305737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 08/22/2024] Open
Abstract
INTRODUCTION Polypharmacy in patients with advanced cancer represents a major public health problem, leading to risk of iatrogenesis, decrease of quality of life and increase of healthcare costs. In the field of geriatrics, health policies have been developed to address polypharmacy through the use of deprescribing tools. Recently, palliative care initiatives have been introduced, yet these have not fully considered the specificities of this population, particularly their perceptions. It is therefore important to better understand patients' perceptions of deprescribing in order to adapt tools and actions to make these approaches more effective. OBJECTIVES The aim is to investigate patients' perceptions of deprescribing in palliative oncology care, and to explore factors that may influence patients' attitudes and beliefs about deprescribing and to validate a specific questionnaire (rPATD) in this population. An ancillary study will investigate the relationship between patients' health literacy and their perception of deprescribing. METHOD A prospective, observational, multicenter study will be conducted using a sequential mixed exploratory design in a population of patients living with advanced cancer and with a physician-estimated life expectancy of less than 1 year. The study will include an initial qualitative phase. Individual semi-structured interviews using a descriptive approach (thematic analysis) will be conducted (upon saturation). Following analysis of the qualitative data, a quantitative study including 300 patients will be realized to meet secondary objectives. Several data will be collected and 2 self-questionnaires will be administered: the BMQ (beliefs about medicine) and rPATD (perception of deprescribing) possibly supplemented by additional items if required by the qualitative analysis. The auxiliary study will be conducted during this second phase, using a validated self-questionnaire to assess patients' level of literacy. CONCLUSION The disparate outcomes will facilitate the understanding of the perception of deprescribing in palliative oncology care, enabling the development of tailored approaches adapted to this population. TRIAL REGISTRATION ClinicalTrials Identifier: NCT06193083.
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Affiliation(s)
- Adrien Evin
- Service de Soins Palliatifs et de Support, CHU de Nantes, Nantes Université, Nantes, France
- INSERM, Methods in Patients-centered Outcomes and Health Research, SPHERE, CHU Tours, CHU Nantes, Tours Université, Nantes Université, Nantes, France
| | - Marianne Bourdon
- INSERM, Methods in Patients-centered Outcomes and Health Research, SPHERE, CHU Tours, CHU Nantes, Tours Université, Nantes Université, Nantes, France
- Integrative Center for Oncology, Angers, Nantes, France
| | - Pierre Nizet
- INSERM, Methods in Patients-centered Outcomes and Health Research, SPHERE, CHU Tours, CHU Nantes, Tours Université, Nantes Université, Nantes, France
- Pharmacie, CHU de Nantes, Nantes Université, Nantes, France
| | - Jean-Benoit Hardouin
- INSERM, Methods in Patients-centered Outcomes and Health Research, SPHERE, CHU Tours, CHU Nantes, Tours Université, Nantes Université, Nantes, France
- Direction de la Recherche et de l’Innovation, Plateforme de Méthodologie et Biostatistique Unit, CHU de Nantes, Nantes Université, Nantes, France
| | - Caroline Victorri-Vigneau
- INSERM, Methods in Patients-centered Outcomes and Health Research, SPHERE, CHU Tours, CHU Nantes, Tours Université, Nantes Université, Nantes, France
- Centre d’évaluation et d’information sur la Pharmacodépendance-addictovigilance, CHU de Nantes, Nantes Université, Nantes, France
| | - Jean-François Huon
- INSERM, Methods in Patients-centered Outcomes and Health Research, SPHERE, CHU Tours, CHU Nantes, Tours Université, Nantes Université, Nantes, France
- Pharmacie, CHU de Nantes, Nantes Université, Nantes, France
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Nguyen-Soenen J, Weir KR, Jungo KT, Perrot B, Fournier JP. Does missing data matter in the revised Patients' Attitudes Towards Deprescribing questionnaire? A systematic review and two case analyses. Res Social Adm Pharm 2024; 20:296-307. [PMID: 38168621 DOI: 10.1016/j.sapharm.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/10/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire was developed to capture beliefs and perceptions of patients about deprescribing. In general, handling of missing data is underreported in survey studies. Underlying mechanisms related to missing data may impact the findings from survey studies. OBJECTIVES The aim of this study was to assess the missing data in studies using the rPATD questionnaire through a systematic review and datasets from two studies. METHODS First, this review updated a systematic review on the rPATD (and other versions). We searched Medline via OVID, EMBASE, Scopus, Web of Science until 31st January 2023. Missing data reporting and methods to handle them were collected. Second, data from two deprescribing studies were analyzed using three methods of missing data handling: complete case analysis, personal mean substitution, and multiple imputation. We compared the scores from each domain and the associations of the domains with two questions from the rPATD to highlight how using different methods can influence the interpretation of study findings. RESULTS We identified 49 studies: 31 (63 %) from this study and 18 (37 %) from the original systematic review. The question or domain with the most missing data could be identified in 9 studies (18.4 %). Missing data management was reported in 19 studies (38.8 %). In one case analysis, the "Burden" domain was significantly associated with the question "I would like to try stopping one of my medicines to see how I feel without it" using complete case analysis (p = 0.044) or multiple imputation (p = 0.038), but not when using personal mean substitution (p = 0.057). CONCLUSIONS Missing data and methods used to handle missing data were underreported in studies using the rPATD questionnaire. The methods should be chosen carefully as our analyses from two distinct studies suggest that they may impact the interpretation of the findings from the questionnaire.
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Affiliation(s)
- Jérôme Nguyen-Soenen
- SPHERE - UMR INSERM 1246, Nantes Université, Université de Tours, France; Département de Médecine Générale, Faculté de Médecine, Nantes Université, France.
| | - Kristie Rebecca Weir
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Katharina Tabea Jungo
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Center for Healthcare Delivery Sciences (C4HDS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Bastien Perrot
- SPHERE - UMR INSERM 1246, Nantes Université, Université de Tours, France; Direction de la recherche, Plateforme de Méthodologie et Biostatistique, CHU Nantes, Nantes, France
| | - Jean-Pascal Fournier
- SPHERE - UMR INSERM 1246, Nantes Université, Université de Tours, France; Département de Médecine Générale, Faculté de Médecine, Nantes Université, France
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Bucsa C, Onea M, Rusu A, Farcas A, Porojan M, Dumitrascu D, Iaru I, Leucuta D, Mogosan C, Reeve E, Moga D. Translation, cultural adaptation and validation of the revised patients' attitudes towards deprescribing (rPATD) questionnaire in Romanian older adults. Res Social Adm Pharm 2023; 19:1471-1479. [PMID: 37495451 DOI: 10.1016/j.sapharm.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Deprescribing is part of ensuring appropriate medication use and may reduce medication-related harm. Capturing the beliefs and attitudes of patients towards deprescribing by using a validated tool may support optimizing medication use in practice. OBJECTIVES To translate, culturally adapt and validate the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire in Romanian and to investigate the attitudes and beliefs of older adults towards deprescribing. METHODS The rPATD questionnaire was translated using forward-backward translation into Romanian and culturally adapted. The psychometric properties were evaluated in older adults ≥65 years of age. Structural validity was assessed by item load on factors using an exploratory factor analysis (EFA) which was compared to the original English version and the internal consistency by Cronbach's alpha. Construct validity was evaluated by calculating the Spearman's rank correlation coefficients between the factor scores obtained using the revised version of the Romanian rPATD and scores on the Beliefs about Medicines Questionnaire (BMQ) Specific Concerns Romanian version. Floor and ceiling effect were also examined. RESULTS We translated the questionnaire and administered it to 224 participants (median age 72 years [interquartile range: 68.0; 77.0]). In the EFA individual items loaded onto 4 factors, grouped similarly to the English version (Involvement, Burden, Appropriateness, Concerns about Stopping factors). Two items from each of the Involvement and Appropriateness factors were removed to improve factor loading and avoid cross-loading. The Cronbach's alpha values for the 4 factors ranged between 0.522 and 0.773. The scores for Burden and Concerns about Stopping factors were found to be positively correlated with BMQ Specific Concerns score. We identified a ceiling effect for one of the four factors (Involvement) and no floor effects. CONCLUSIONS The Romanian rPATD was validated in 4 factor structure similar to the original English questionnaire. The Romanian version of the questionnaire may support the health care professionals in Romania to initiate and support patient-centered deprescribing.
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Affiliation(s)
- C Bucsa
- Pharmacovigilance Research Center, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - M Onea
- Pharmacovigilance Research Center, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - A Rusu
- Department of Diabetes and Nutrition Diseases, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - A Farcas
- Pharmacovigilance Research Center, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - M Porojan
- 2nd Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - D Dumitrascu
- 2nd Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - I Iaru
- Department of Pharmacology, Physiology and Physiopathology, Faculty of Pharmacy, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - D Leucuta
- Department of Medical Informatics and Biostatistics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C Mogosan
- Department of Pharmacology, Physiology and Physiopathology, Faculty of Pharmacy, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - E Reeve
- Monash University, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Melbourne, VIC, Australia; University of South Australia, Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, Adelaide, SA, Australia
| | - D Moga
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA; Institute for Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Kentucky, Lexington, KY, USA; Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA; Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
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Waterloo Handedness Questionnaire: Cross-Cultural Adaptation and Psychometric Properties of the Arabic Version. Occup Ther Int 2022; 2022:3026415. [PMID: 36304079 PMCID: PMC9581684 DOI: 10.1155/2022/3026415] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/29/2022] [Indexed: 11/23/2022] Open
Abstract
Handedness is one of the most studied behavioural predictors of cerebral lateralization. Assessing handedness is often essential in neuropsychology and motor behaviour research. Thus, it is important that self-reported assessment tools for determining handedness are available in multiple languages for different cultures. The purpose of the present study was to conduct a translation and cross-cultural adaptation of the Waterloo Handedness Questionnaire into the Arabic language and to assess its psychometric properties. Two independent forward translations were performed by two native Arabic speakers and then synthesized into one version. The synthesized version was backtranslated into English by two independent bilingual translators. An expert committee was formed to review the translation and adaptation process. A final Arabic version of the WHQ was obtained, the WHQ-Ar. Two hundred and ninety adult Arabic speakers were recruited to participate in the study and investigate the properties of the WHQ-Ar. Results showed that the WHQ-Ar had no floor or ceiling effect. For construct validity, results of factor analysis revealed that the WHQ-Ar had two dimensions. Further, the WHQ-Ar had excellent internal consistency with Cronbach′s alpha = 0.93. For test-retest reliability, intraclass correlation coefficient score was 0.94. The Bland-Altman plot showed acceptable agreement between test and retest scores. Therefore, the WHQ-Ar is a valid, reliable tool and ready for use among the Arabic-speaking population for determining handedness.
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