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Reliability and validity of the Maltese version of the Perception of Anticoagulant Treatment Questionnaire (PACT-Q)

Authors Riva N, Borg Xuereb C, Makris M, Ageno W, Gatt A

Received 4 March 2019

Accepted for publication 12 April 2019

Published 19 June 2019 Volume 2019:13 Pages 969—979


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Video abstract presented by Christian Borg Xuereb, Nicoletta Riva and Alex Gatt.

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Nicoletta Riva,1 Christian Borg Xuereb,2 Michael Makris,3 Walter Ageno,4 Alex Gatt1

1Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta; 2Department of Gerontology and Dementia Studies, Faculty for Social Wellbeing, University of Malta, Msida, Malta; 3Sheffield Haemophilia and Thrombosis Centre, University of Sheffield, Sheffield, UK; 4Department of Medicine and Surgery, University of Insubria, Varese, Italy

Purpose: Anticoagulant therapy has an impact on the health-related quality of life, as it is a chronic treatment for most clinical indications and also requires some lifestyle changes. Since there was no validated questionnaire available in the Maltese language, the aim of our study was to translate and validate the Perception of Anticoagulant Treatment Questionnaire (PACT-Q2).
Patients and methods: The PACT-Q2 explores two dimensions (convenience and anticoagulant treatment satisfaction). Forward and backward translations were performed. The Maltese version of the PACT-Q2 was administered to 174 patients on warfarin treatment enrolled from different anticoagulation clinics in Malta. Reliability was assessed through internal consistency (Cronbach’s alpha) and test-retest (intraclass correlation coefficient [ICC]). Validity was assessed through floor/ceiling effect, factor analysis (root mean square error of approximation [RMSEA], standardized root mean squared residual [SRMR], goodness-of-fit index [GFI], adjusted goodness-of-fit index [AGFI], comparative fit index [CFI]), subscales correlation and known-group validity.
Results: Reliability was very good for the convenience subscale (Cronbach’s alpha 0.86, ICC 0.87), but less good for the satisfaction subscale (Cronbach’s alpha 0.62, ICC 0.40). Floor effect was 0%; ceiling effect was low (6.3% convenience, 1.2% satisfaction). Fit parameters were close to acceptable cut-offs (RMSEA =0.09, SRMR =0.10, GFI =0.82, AGFI =0.78, CFI =0.79). There was no correlation between the two subscales (r=0.01, p=0.83). Patients with history of bleeding showed lower convenience (r=−0.16, p=0.08) and lower satisfaction (r=−0.21, p=0.01).
Conclusions: Our results support the finding that the Maltese translation of the PACT-Q2 is a valid and reliable instrument.

Keywords: atrial fibrillation, psychometrics, quality of life, surveys and questionnaires, venous thromboembolism, warfarin

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