فهرست مطالب fatemeh hendouei

 Studies showed that the adherence to practice guidelines is associated with a higher quality of care and better patient’s outcomes. In psychiatric practice, there is a quality gap between Practice guidelines (PGs) and routine clinical practice for the patients with schizophrenia which potentially hinders their recovery. One of the important reasons for this persistent gap is the lack of systematic methods to evaluate prescribers’ adherence to practice guidelines.

 This study aimed to develop and validate a medication assessment tool (MAT) to evaluate prescribers’ adherence to pharmacotherapy recommendations in PGs during the acute phase of schizophrenia (APSCZ) in Iran (MATAPSCZ).

 This methodological cross-sectional study was conducted from August 2021 to April 2022. According to the literature review and discussions in the research group, an item pool of 91 items was developed. Then face and content validity of the scale were evaluated. Then, exploratory factor analysis (EFA) was used to specify the factor structure. At last, the reliability and responsiveness of the scale were assessed. The study sample consisted of 200 Iranian psychiatrists and final-year psychiatry residents.

 Eleven items were merged in qualitative content validity. Then, sixteen and six items were excluded from the scale in terms of having low content validity ratios and corrected item-total correlation, respectively. In exploratory factor analysis, the remaining 48 items were classified into six factors, which included 50.1% of the total variance. Based on the results, Cronbach’s alpha, and McDonald’s omega of all factors were higher than 0.7, AIC was 0.2 to 0.4 for all factors, and the intraclass correlation coefficient for MATAPSCZ was 0.914. The standard error of measurement was ± 4.5, and the percentage of minimum detectable change for the tool was calculated to be 6.15%, which indicates its excellent responsiveness.

 The MATAPSCZ has acceptable psychometric properties and could be a useful tool to evaluate prescribers’ adherence to practice guidelines pharmacotherapy recommendations during the APSCZ.

 In the last decades, bipolar disorder treatments have undergone a gradual shift away from relying on clinical expertise to adopting evidence-based practice guidelines and expert consensus, leading to an improvement in medical care safety, patient performance, and quality of life. Nonetheless, suboptimal prescribing has remained an issue, and there is an excellent opportunity for improving the care standards to reduce symptoms’ recurrence, frequent hospitalizations, and costs.

 This study aimed to develop and validate a medication assessment tool for evaluating prescribers’ adherence to pharmacotherapy recommendations outlined in practice guidelines during the acute phase of bipolar disorder in Iran (MATAPBD).

 This mixed-method study was conducted from August 2021 to May 2022. A 54-item pool was developed based on the results from the literature review and research group discussion. The validity (i.e., face, content, and construct) and reliability (i.e., stability and internal consistency) of the tool were evaluated.

 Four items were rewritten in qualitative content validity. Then, eleven and five items were excluded from the scale in terms of having low content validity ratios and corrected item-total correlation, respectively. The construct validity of the MATAPBD was assessed by adopting the maximum-likelihood exploratory factor analysis method and Promax rotation. The number of latent factors was calculated by performing Horn’s parallel analysis. In exploratory factor analysis, the remaining 17 items were categorized into four factors which explained 57.97% of the total extracted variance. Cronbach’s alpha and McDonald’s omega of all factors were > 0.7, and the intraclass correlation coefficient was 0.914 revealing the strong reliability of MATAPBD.

 The MATAPBD had good psychometric properties and may have been a valuable tool to evaluate prescribers’ adherence to practice guideline recommendations during the acute phase of bipolar disorder.