Validity and reliability study of malay version brief treatment outcome measure (BTOM) as a treatment outcome measuring tool for methadone maintenance therapy (MMT) service in Malaysia

Abstract

Methadone Maintenance Therapy (MMT) is one of the harm reduction approaches meant to curb illicit opioid use in the country. Instruments such as brief version World Health Organization Quality of Life (WHOQOL-BREF) and Opioid Treatment Index (OTI) are currently being used in clinical practice to measure the treatment outcomes of MMT. However, they were quite lengthy and most importantly they do not comprehensively evaluate the severity of opioid dependence among clients. The Brief Treatment Outcome Measure (BTOM) is an instrument developed to evaluate the treatment outcomes of clients attending to addiction treatment program such as MMT. To date, there is no research done relating to the cultural adaptation of the BTOM in Malay-speaking population. The objective of this study is to develop, translate and modify a Malay-version of the BTOM as a potential tool for treatment outcome evaluation among MMT patients. This study employed a cross-cultural adaptation study. The original BTOM was modified by applying cross-cultural adaptation procedures to suit to Malaysian context and cultures. The procedures comprised of conducting forward and reverse translation, synthesis of the translations, evaluation of the synthesized version by experts committee, discussion with original authors and pilot study on 30 eligible clients. The assessment covered the aspect of semantic, idiomatic, experiential and conceptual equivalences. Several terms that were not common in Malaysian setting, were omitted and replaced. Terms that are unlikely to be easily understood by clients were rephrased and further explained. 109 eligible clients were recruited into the study from five Health clinics in Kuantan area. Internal reliability of the BTOM in the actual study reported an overall unsatisfactory internal reliability for SDS (? = 0.34) and SFS (? = 0.14), while the remaining BTOM scores were satisfactory. Factor analysis on SDS showed good item construct, while SFS showed unfavorable item construct. The cross-cultural adaptation procedures conducted yielded a final Malay-version BTOM instrument. However, only BBVER, ODUS, Health Scale and PFS can be used in future studies, while SDS and SFS require further investigation to attest their psychometric properties in Malaysian population for clinical practice and research.