CHATD Questionnaire: Development, Validation and Evaluation of Child and Parent Attitudes Towards Deprescribing

Polypharmacy exists in children and young people (CYP), generating clinician concern and a desire to deprescribe. This study validated and applied a questionnaire to assess the attitudes of CYP and their parents/guardians towards polypharmacy and deprescribing.

A paediatric version of the Revised Patient Attitudes Towards Deprescribing (rPATD) was developed-the Child and Parent Attitudes Towards Deprescribing (CHATD) questionnaire. Validation included: Content evaluation, face validity, factor analysis, internal reliability and test re-test reliability. Participants were prospectively recruited from three UK paediatric hospitals. The questionnaire comprised two global questions and four factors concerning participants medications: burden, appropriateness, concerns about stopping and involvement. Responses were recorded on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree; appropriateness reverse scored).

A total of 216 responses were analysed (149 parents, 67 CYP). Factor analysis supported the four-factor structure, with good internal reliability (McDonald's ω_t ≥ 0.7) and test-retest reliability (all ICCs >0.75). Compared with parents, CYP reported greater medication burden (3.0 vs. 2.4, p = .003), lower perceived appropriateness (3.6 vs. 4.2, p = .008) and less involvement (3.8 vs. 4.8, p < .001). Most parents (70%) and 55% of CYPs were happy to have a medication deprescribed if the doctor agreed. Among CYP, higher appropriateness scores were associated with greater satisfaction with current medications (OR 9.34, 95% CI 3.39-25.77) and lower willingness to stop a medicine (OR 0.21, 95% CI 0.09-0.48).

CHATD is a valid, reliable tool for assessing deprescribing attitudes among CYP and parents. Most respondents were willing to consider deprescribing under medical guidance.