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The Patient Perceptions of Deprescribing (PPoD) Survey: Short-Form Development

Drugs & Aging volume 37, pages 909–916 (2020)Cite this article

Abstract

Introduction

Deprescribing, the intentional reduction of medication, is recognized as an important component of clinical care; however, standardized identification of patient attitudes and beliefs that contribute to deprescribing may be limited due to the length of current surveys. We sought to develop a short-form (≤ 15 items) of the patient perceptions of deprescribing (PPoD) questionnaire, a validated 30-item instrument that assesses dimensions relevant to deprescribing, to be used in clinical and research settings.

Methods

We conducted a secondary analysis of data from 803 US veteran respondents to the original PPoD survey, randomly divided into derivation and validation samples. In the derivation sample, we used ordinary least squares linear regression with R2 model selection to identify candidate items reflective of overall readiness for deprescribing. We then used iterative multitrait analysis, followed by confirmatory factor analysis (CFA) in the validation sample to assess the psychometric properties of the proposed short form.

Results

The resulting short-form PPoD consisted of 11 items representing two overarching domains reflective of overall readiness for deprescribing: ‘Motivation for Deprescribing’ and ‘Primary Care Provider Relationship’. CFA fit statistics supported the proposed structure and the two new scales demonstrated high internal consistency reliability (Cronbach alphas: 0.82 and 0.91, respectively) and good discriminant validity (interscale correlation − 0.30).

Discussion

The proposed short-form PPoD captures two important sources of variance in patient readiness for deprescribing: motivation and patients’ relationships with their primary care providers. This brief, 11-item survey may help foster the inclusion of patient perceptions into clinical decision making for deprescribing to yield safer, more appropriate medication use.

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Authors and Affiliations

  1. Section of General Internal Medicine (152G), VA Boston Healthcare System, 150 S. Huntington Ave, Boston, MA, 02130, USA

    Amy M. Linsky

  2. Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System and ENRM Veterans Affairs Medical Center, Boston/Bedford, MA, USA

    Amy M. Linsky & Kelly Stolzmann

  3. Section of General Internal Medicine, Boston Medical Center, Boston, MA, USA

    Amy M. Linsky

  4. Patient Experience Survey Program, VHA Office of Reporting, Analytics, Performance, Improvement and Deployment, Bedford, MA, USA

    Mark Meterko

  5. Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA

    Mark Meterko

Authors
  1. Amy M. Linsky
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  3. Mark Meterko
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Correspondence to Amy M. Linsky.

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Funding

Data collection and analyses were performed while Dr. Linsky was supported by a Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development Career Development Award (CDA12-166), and the study was conducted using resources from the VA Boston Healthcare System. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Conflict of Interest

To the best of our knowledge, no conflicts of interest, financial or otherwise, exist.

Ethics Approval

This study was approved by the Institutional Review Board of the VA Boston Healthcare System.

Consent to participate

Implied informed consent, indicated by survey completion, was obtained from all individual participants included in the study.

Consent for publication

Not applicable.

Data and Code Availability

Data are available upon request and with approval of the Institutional Privacy Officer.

Author Contributions

All authors contributed to the study conception and design. Material preparation and data collection and analysis were performed by Amy Linsky and Kelly Stolzmann. Data interpretation was performed by all authors. The first draft of the manuscript was written by Amy Linsky and all authors commented on subsequent versions of the manuscript. All authors read and approved the final version of the manuscript.

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Linsky, A.M., Stolzmann, K. & Meterko, M. The Patient Perceptions of Deprescribing (PPoD) Survey: Short-Form Development. Drugs Aging 37, 909–916 (2020). https://doi.org/10.1007/s40266-020-00802-w

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