Expert Validation and Refinement of a Tool for Assessing Patient Experiences with Deprescribing Interventions

Introduction: A quality improvement tool that assesses the association between patients’ experiences with the deprescribing intervention and its translation into improved healthcare quality and medication self-management is crucial. This study advances the development of the Deprescribing Evaluation and Quality Improvement (DEQI) instrument by utilizing a Delphi panel of experts to assess the instrument's constructs, dimensions, and items. Methods: Content analysis of qualitative interviews was used to generate constructs, dimensions, and items. Deprescribing experts, comprising physicians and pharmacists (N=21), were selected and invited to join a Delphi panel. The Delphi technique was employed in two rounds. In the first round, experts evaluated the relevance of 37 draft constructs and dimensions (C&D). In the second round, the experts rated 75 items for relevance and clarity. Results: There was a 95% response in both Rounds 1 and 2. A total of 7 C&D (19%) were eliminated after Round 1. Nineteen items (25%) with an item-level content validity index below the set threshold for relevance were eliminated after Round 2. Duplicates were discarded. Items below the set threshold for clarity were revised based on feedback comments. Four items were combined into two. Ultimately, the 75-item survey was reduced to 53 items. An additional five new items were added, bringing the total to 58 items. Conclusion: Creating an instrument to assess and improve deprescribing interventions depends on input from the professionals who will utilize the data. Panelists successfully reached consensus and validated the content of the DEQI instrument.