Mansoor L E, Dowse R
Faculty of Pharmacy, Rhodes University, Grahamstown 6140, South Africa.
J Clin Pharm Ther. 2006 Feb;31(1):7-15. doi: 10.1111/j.1365-2710.2006.00696.x.
Providing written medicines information is being legislated in an increasing number of countries worldwide, with the patient information leaflet (PIL) being the most widely used method for conveying health information. The impact of providing such information on adherence to therapy is reportedly unpredictable. Therapy for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and related opportunistic infections usually involves polytherapy and complex regimens, both of which are risk factors for non-adherence. The objective of this study was to assess the impact of medicines information on adherence to chronic co-trimoxazole therapy in low-literate HIV/AIDS patients.
Two different PILs were designed for co-trimoxazole tablets and were available in both English and isiXhosa. Participants were randomly allocated to a control group (receiving no PIL), group A (receiving a "complex PIL") and group B (receiving a "simple PIL" incorporating pictograms). At the first interview, demographic data were collected and the time, date and day that the participant would take his/her first tablet of the month's course was also documented. In a follow-up interview adherence to therapy was assessed using two methods; self-report and tablet count.
The medicines information materials incorporating simple text and pictograms resulted in significantly improved adherence to therapy in the short term, whereas a non-significant increase in adherence was associated with the availability of the more complex information. This was shown by both the self-reported assessment as well as the tablet count.
This research suggests that appropriately designed written material can have a positive impact in improving adherence and, together with verbal consultation, are essential for enabling patients to make appropriate decisions about their medicine taking.
在世界上越来越多的国家，提供书面药品信息已被立法，患者信息传单（PIL）是传达健康信息最广泛使用的方法。据报道，提供此类信息对治疗依从性的影响是不可预测的。人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）及相关机会性感染的治疗通常涉及联合治疗和复杂的治疗方案，这两者都是导致不依从的危险因素。本研究的目的是评估药品信息对低文化水平HIV/AIDS患者慢性复方新诺明治疗依从性的影响。
为复方新诺明片剂设计了两种不同的患者信息传单，有英文和科萨语两种版本。参与者被随机分配到对照组（不接受患者信息传单）、A组（接受“复杂患者信息传单”）和B组（接受包含象形图的“简单患者信息传单”）。在第一次访谈时，收集了人口统计学数据，并记录了参与者将服用本月疗程第一片药的时间、日期和星期。在后续访谈中，使用两种方法评估治疗依从性；自我报告和药片计数。
包含简单文字和象形图的药品信息材料在短期内显著提高了治疗依从性，而更复杂的信息对依从性的提高没有显著影响。自我报告评估和药片计数均表明了这一点。
本研究表明，设计恰当的书面材料对提高依从性有积极影响，并且与口头咨询一起，对于使患者能够就其用药做出适当决定至关重要。
