Development and validation of the Patient Involvement in Medication Communication at Hospital discharge Questionnaire (PIMCH-Q)

BACKGROUND: Medication-related problems are common after hospital discharge, often due to inadequate communication about changes made to medication therapy. Patients' ability to understand and manage medication changes after discharge is essential for safe and effective treatment. However, existing patient-reported outcome measures (PROMs) do not adequately capture how patients perceive their involvement or understanding of peri- and post-discharge medication communication. The aim of this study was to develop the Patient Involvement in Medication Communication at Hospital discharge Questionnaire (PIMCH-Q) and to evaluate its content validity, structural validity, and internal consistency. METHODS: The 8-item PIMCH-Q was developed based on literature and expert input. Content validity was assessed through expert panel review and patient interviews. Structural validity was evaluated using exploratory and confirmatory factor analyses (EFA, CFA) based on responses from recently discharged patients (n=57). Internal consistency was assessed using McDonald's omega. RESULTS: Eleven patients participated in interviews. They found the questionnaire relevant and easy to understand. Exploratory factor analysis suggested a three-factor structure representing perceived involvement in medication decisions, knowledge and understanding of medication changes, and confidence in medication self-management. One item did not show a clear primary loading and was excluded, resulting in a seven-item factor structure. Confirmatory factor analysis demonstrated good model fit (χ²(11) = 6.58; CFI = 1.00; TLI = 1.01; RMSEA = 0.00; SRMR = 0.055). Internal consistency was high (ω total = 0.95). CONCLUSIONS: This study provides preliminary support for the validity and internal consistency of the PIMCH-Q as a PROM for assessing patient experiences of medication communication at hospital discharge. The findings also suggest that the PIMCH-Q may be useful in both research and clinical practice. Further validation in larger and independent samples is warranted.