Translation, cross-cultural adaptation and validation of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire in Japanese.

Background: Deprescribing, a structured process aimed at improving medication safety, requires an approach that aligns with the beliefs and attitudes of patients and caregivers. The revised Patients' Attitudes Towards Deprescribing (rPATD), widely used across countries and disease contexts, may be able to capture the attitudes of older adults and caregivers toward deprescribing in Japan. Objectives: To translate rPATD into Japanese and assess its cultural adaptability, and to examine its applicability to older adults and caregivers in Japan. Methods: rPATD was translated into Japanese using a forward-back translation process. Psychometric properties were evaluated among older adults aged 65 years or older who used community pharmacies and caregivers recruited from a web panel. Face and content validity were assessed during the translation process, construct validity was examined using exploratory factor analysis (EFA), and reliability was evaluated using Cronbach's alpha and test-retest analysis with the intra-class correlation coefficient (ICC). Results: 384 older adults and 219 caregivers were included in the analysis. EFA results showed that, the same as the original version, the four factors (burden, belief in appropriateness, concern about stopping, and involvement) were identified for both the older adults and caregivers. Internal consistency was confirmed for all factors related to older adults and caregivers (Cronbach's alpha >0.70). Test-retest reliability was good for all factors (ICC >0.75). Conclusions: The Japanese version of the rPATD demonstrated good psychometric properties and might be used to assess attitudes towards deprescribing among older adults and caregivers living in Japan.