Translation to English, cross-cultural adaptation, and pilot testing of the self-report questionnaire on swallowing difficulties with medication intake and coping strategies (SWAMECO) for adults with polypharmacy
Isabelle Arnet, Markus Messerli, Jana Oezvegyi, Kurt E. Hersberger, Laura J. Sahm
Abstract
OBJECTIVES: To translate the SWAMECO from German into English; to complete content and face validity with healthcare professionals (HCPs) and with patients from the target population that is, community-dwelling adult patients taking three or more medicines for three or more months. DESIGN: and included translation and cross-cultural adaptation, and cognitive testing among selected HCPs and patients. As the SWAMECO questionnaire is a screening instrument, pilot testing was performed in the target population. SETTING: Three community pharmacies in and around Cork (Ireland) recruited patients for interviews and pilot testing. PARTICIPANTS: Community-dwelling patients with ≥3 oral medications for ≥3 months, aged ≥18 years. OUTCOME MEASURES: Answers to the SWAMECO questionnaire; clarity of each question, each instruction and each response format. RESULTS: . Revisions included rewording; deleting of two questions; using of colour to signpost that is, where to skip questions that were not applicable to the participants; and replacement of the A-14 medication adherence scale with three validated items. Of the 66 patients enrolled for pilot testing, eight (12.1%) indicated swallowing difficulties. Difficulties with ingesting foods or liquids correlated with swallowing difficulties (p=0.001). All patients perceived discomfort (mean 6.9 on a Visual Analogue Scale from 0 to 10). Patients with swallowing difficulties were significantly more likely to report modifying their medicines (p=0.004) and having poorer medication adherence (p=0.028) than those who had no swallowing difficulties. CONCLUSIONS: The version of the SWAMECO questionnaire in English contains 28 items and is ready for use in adults with polypharmacy.