Development, Translation, and Validation of QUM-Qatar: A Questionnaire on Patients’ Knowledge, Attitude, and Practices towards Unused Medications in Qatar Homes

Abstract Background Unused medications in homes pose significant health, economic, and environmental risks. Patients are the medications end users and their knowledge, attitude, and practices play an important role towards medication use and wastage. Thus, a valid instrument to reliably measure patients’ KAP towards these vital commodities may help manage their risks. Objective To develop, translate, and validate a questionnaire that assesses patients’ KAP towards unused medications in Qatar homes (i.e., QUM-Qatar). Setting: This cross-sectional validation study was conducted among randomly selected outpatients visiting Qatar various public and private pharmacies between September 2019 and February 2020. Method Nine experts in the field of pharmacy practice with Qatar contextual background established content validity of the instrument. The questionnaire was quantified by content validity index (CVI). Construct validity was performed using principal component analysis (PCA), whereas internal consistency was determined using Cronbach’s alpha. Statistical analyses were performed by STATA 15 statistical package. Main outcome measure: The psychometric properties of the QUM-Qatar assessment instrument. Results An English/Arabic questionnaire was developed and validated. Content validity in the form of S-CVI/Average and S-CVI/UA was 0.88 and 0.84, respectively, suggesting adequate relevant content of the questionnaire. Variation explained by the multivariate model was: 85.0% for knowledge, 94.8% for attitude, and 89.8% for practice. Cronbach’s alpha coefficients were 0.68, 0.82, 0.84, for knowledge, attitude, and practice domains, respectively. From the psychometric results obtained, this questionnaire validity and reliability were attained. Conclusion The QUM-Qatar instrument has acceptable psychometric properties and has the potential for future use in research and practice to assess patients’ KAP towards unused medications in Qatar and elsewhere. It may subsequently help in improving medication use, storage, and disposal to ultimately help in mitigating the negative health, economic, and environmental impacts of unused medications. Impacts on practice • There is now a valid and reliable English/Arabic language questionnaire to assess patients’ KAP towards unused medications. • Policymakers can utilize this questionnaire to develop evidence-based policies and strategies that manage unused medications and their disposal. • To improve Medication Use Review (MUR), Rational Use of Medicines (RUM), and adherence, it is necessary to consider patient-reported outcomes such as knowledge, attitude, and practices which may eventually reflect on saving health, economic resources, and environment.