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