Validation of Kazakh and Russian Generic Drug Questionnaire

Background: The widespread use of generic drugs (GDs) represents a key strategy for reducing medication costs for patients and the healthcare sector. Promoting the rational use of GDs requires a clear understanding of physicians' knowledge and attitudes, assessed through reliable and culturally validated instruments. This study aimed to adapt and validate the Kazakh and Russian versions of a standardized questionnaire designed to evaluate physicians' knowledge and attitudes toward GDs. The validated tool is intended to support future research, educational programs, and policy efforts aimed at enhancing the rational prescription and utilization of GD in the Republic of Kazakhstan. Methods: The questionnaire underwent a standardized forward-backward translation process in accordance with internationally accepted guidelines for cross-cultural adaptation of survey instruments. A pilot study was subsequently conducted among physicians in Shymkent, Republic of Kazakhstan, to evaluate its clarity and applicability in real-world conditions. To examine the psychometric properties of the Kazakh and Russian versions, Confirmatory Factor Analysis (CFA) was carried out using the Structural Equation Modeling (SEM) module in Jamovi software. In addition, descriptive statistics, standardized factor loadings, factor covariances, and model fit indices were calculated to assess the validity and internal structure of the instrument. Results: Confirmatory Factor Analysis (CFA) supported the hypothesized two-factor model comprising the latent constructs "Information" and "Attitude" in both the Kazakh and Russian versions of the questionnaire. The majority of items demonstrated statistically significant standardized factor loadings, with several exceeding the recommended threshold of 0.70, indicating strong associations with their respective latent variables. The estimated correlation between the two factors was moderate in the Kazakh version (r = 0.599) and strong in the Russian version (r = 0.780), suggesting a meaningful conceptual relationship between physicians' knowledge and attitudes toward generic drugs. Conclusion: The psychometric evaluation confirmed that the questionnaire has an adequate internal structure, with most items showing significant factor loadings and acceptable model fit. These findings support its use as a reliable tool for assessing physicians' awareness and attitudes toward generic medicines in Kazakhstan.

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