Introduction: A validation project of preventable drug-related morbidity (PDRM) indicators in community pharmacy has recently started in Portugal; the same protocol will be used in Sweden and the UK as part of a collaborative study. One of the first phases of cross-national adaptation of an instrument is translation. This process has been extensively described for more subjective tools, such as Health Related Quality of Life scales, mostly based on expert opinion. The optimum translation procedure is unknown.

Objective: To develop a method of translation for PDRM indicators to ensure equivalence between the source and target languages

Methods: A literature review was performed to design the following translation method: (1) Forward translation to Portuguese by one of the authors (MG) using a pool of 62 PDRM indicators (2) Blind backward translation by two independent Portuguese pharmacists proficient in English (3) Analysis of discrepancies by a team of two British pharmacists facilitated by MG, using consensus to establish if a discrepancy is relevant (4) Rephrasing of PDRM indicators when relevant discrepancies exist (5) Pilot testing of the instrument using the source and target language versions in an independent bilingual sample followed by correlation of responses in both languages (6) Re-evaluation of the translation if necessary. A focus group was conducted to explore British pharmacists' views on the applicability of PDRM indicators in community pharmacy and to identify barriers and facilitators to the use of PDRM indicators in community practice in this country. A similar focus group will be conducted in Portugal.

Results: From the work done so far in translation it seems discrepancies between the original and translated version do not affect language equivalence. Data from the focus group indicates that cross-cultural differences regarding PDRM indicators are unlikely. Results will be completed in January 2004.

Conclusions: Preliminary results suggest that the translation methodology is appropriate. PDRM indicators are of a clinical nature and consequently less prone to subjectivity than instruments with items assessing feelings or emotions, which require a more complex process of translation.

References
• Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990; 47(3):533-543.
• Morris CJ, Cantrill JA, Hepler CD, Noyce PR. Preventing drug-related morbidity--determining valid indicators. Int J Qual Health Care 2002; 14(3):183-198.