The medication-related burden quality of life (MRB-QoL) Arabic tool: Exploratory factor analysis and psychometric evaluation

Abstract

Background: The Medication-Related Burden Quality of Life (MRB-QoL) is a patient-reported measure of medicines burden on functioning and well-being in people with long-term conditions (LTCs). The Arabic version has demonstrated good content validity; however, no data is available on its other psychometric properties.

Objectives: To evaluate the reliability and validity of the Arabic MRB-QoL tool.

Methods: Four hundred patients (≥18 years) with LTCs were recruited from a tertiary hospital in the United Arab Emirates. Exploratory factor analysis (EFA) was performed using Principal Axis Factoring for extraction and Oblimin rotation. Cronbach's alpha, intraclass correlation coefficient (ICC), and minimum detectable change (MDC) assessed internal consistency, test-retest reliability, and measurement error, respectively. Structural, Known-group, convergent, and discriminant validity were evaluated using EFA, Mann Whitney U test, and Spearman's rank correlations tests, respectively. Convergent validity (r > 0.3, moderate to high correlations) and discriminant validity (r < 0.3, weak correlations) were examined through correlation with the Medication Regimen Complexity Index (MRCI), Drug Burden Index (DBI), and 12-item Short Form Health Survey (SF-12) measures. Known-group validity was assessed by comparing MRB-QoL scores across clinically diverse groups.

Results: EFA revealed a 31-item, four-factor structure accounting for 78.5 % of the variance. Reliability results showed good internal consistency (Cronbach's α = 0.973) and test-retest reliability (ICC = 0.994). The MDC for the total MRB-QoL was 3.89, indicating that a change of more than 4 points between 2 measurements reflects a true difference with 95 % confidence. There were weak correlations between domains of MRB-QoL and MRCI (r 0.120 to 0.152) indicating discriminant validity. Correlations between the mental component summary of the SF-12 and MRB-QoL (r = -0.387) and its domains (r -0.357 to -0.374) suggested convergent validity. Patients with polypharmacy and multimorbidity had higher median MRB-QoL scores, showing known-group validity.

Conclusion: This study demonstrated that the Arabic MRB-QoL is a valid and reliable medication-related burden (MRB) measure with good construct validity, including structural, known-group, convergent, and discriminant validity. It also shows excellent reliability, with high internal consistency, low measurement error, and good test-retest reliability. These findings support its use as a psychometrically robust measure for assessing MRB and facilitating person-centred medicines optimisation services in Arabic-speaking populations.

Keywords: Arabic; EFA; MRB-QoL; Psychometric properties; Reliability; Validity.