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May 15, 2026International Journal for Quality in Health Care0 citationsOpen Access

Methodological evaluation of the psychometric properties of medication-related quality indicators in residential aged care homes: A systematic review

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LLLakeesha S LiyanageMNMark NauntonLCLouise S Cox

Key Points

  • This study evaluates the psychometric properties of medication-related quality indicators used in residential aged care homes.
  • Systematic search conducted across databases including CINAHL, MEDLINE, PsycINFO, Scopus, and Web of Science Core Collection until December 2025.
  • 21 full-text studies selected post screening based on inclusion/exclusion criteria and assessed using the Mixed Methods Appraisal Tool.
  • Data on medication-related QIs, their psychometric properties, and methodologies used in the studies were extracted and critically analyzed.
  • Identified 15,247 studies, leading to 21 included full-text studies with a mean methodological quality score of 60%.
  • Validity was reported in 12 studies, reliability in 9 studies, while feasibility was highlighted in 8 studies as key psychometric properties.
  • The Delphi method was predominantly used for assessing validity and feasibility of the medication-related QIs.

Abstract

Abstract Background Quality indicators (QIs) are important for tracking and enhancing healthcare quality. In residential aged care homes (RACHs), medication-related QIs help ensure the quality of medication usage and patient care. To ensure the effective use of QIs, it is essential that they are reliable and satisfy other psychometric properties. This study explored the psychometric properties, including validity, reliability, feasibility, applicability, sensitivity, measurability, appropriateness and usefulness, of medication-related QIs used in RACHs, as well as the methodologies employed in studies evaluating these QIs. Methods A systematic search was conducted using CINAHL, MEDLINE, PsycINFO, Scopus, and Web of Science Core Collection, covering studies published since inception until December 2025. Covidence software was used for title and abstract screening, and full-text reviewing. Medication-related QIs, psychometric properties evaluated, and the employed methodology were extracted from the studies and were critically analysed to provide an understanding of current QI evaluation techniques. Results The search identified 15,247 studies. After removing duplicates and applying inclusion/exclusion criteria, 21 full-text studies were included, with an average methodological quality score of 60% based on the Mixed Methods Appraisal Tool. Psychotropic drug use and polypharmacy were commonly tested medication-related QIs. Validity (reported in 12 studies), reliability (in 9 studies), and feasibility (in 8 studies) were the most frequently assessed psychometric properties. The Delphi method was the primary approach for validity and feasibility testing. Conclusions There were inconsistencies among the methods used for testing the psychometric properties of the QIs. This highlights the need for a standardised protocol for testing medication-related QIs for use in aged care to ensure their reliability and effectiveness.

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Cite This Study

Liyanage et al. (2026) studied this question.

synapsesocial.com/papers/6a06b8dfe7dec685947ab629https://doi.org/10.1093/intqhc/mzag063
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