Department of Clinical Pharmacology, University of Medical Center Groningen, Graduate School for Health Research Share, University of Groningen, the Netherlands.
J Cardiovasc Nurs. 2011 May-Jun;26(3):250-60. doi: 10.1097/JCN.0b013e318200ed94.
Patients with heart failure (HF) often perceive adverse drug events (ADEs), affecting quality of life. For weighing the benefits and burden of medication in HF care, knowledge on patients' perception of ADEs is needed. Our aim was to assess these ADE perceptions and to identify factors related to these perceptions.
A cross-sectional study was performed including HF patients recruited from primary care and outpatient clinics. Patients were included in the analysis if they perceived an ADE in the past 4 weeks. This information was collected using an open-ended question and a symptom checklist. Data on ADE perception were obtained using a modified version of the Revised Illness Perception Questionnaire. Demographic, clinical, and ADE characteristics were collected by self-administered questionnaire and chart review. The relations between these factors and ADE perceptions were analyzed using regression analyses.
In total, 261 HF patients perceived an ADE and completed the questionnaire. Patients reported 814 ADEs, of which 26% of the patients reported dizziness and 24% reported dry mouth as being the most prevalent. Almost half of the patients (46%) perceived their ADE as something serious, with major consequences for their daily life (40%) and reported to be worried (36%) about the ADE. Patients perceived the ADE as a chronic problem (91%), and the majority believed more in the ability of the health care provider to control the ADE (61%) than in their own ability (46%). Demographic and clinical variables had a limited contribution to the explained variance of ADE perceptions after adjusting for ADE characteristics, such as perceived severity.
Patients with HF perceive particular negative consequences and emotional distress of symptomatic ADE. Open communication between patients and providers with attention for patients ADE perceptions would be valuable during the decision process of ADE management and may result in a regimen aligned with patients' preferences and needs.
心力衰竭（HF）患者常能感知到不良反应事件（ADE），这会影响生活质量。为了权衡 HF 治疗中药物的获益与负担，需要了解患者对 ADE 的感知。我们旨在评估这些 ADE 感知，并确定与这些感知相关的因素。
这是一项横断面研究，纳入了来自初级保健和门诊诊所的 HF 患者。如果患者在过去 4 周内感知到 ADE，则将其纳入分析。使用开放式问题和症状检查表收集这些信息。使用修订后的疾病感知问卷的改良版本获取关于 ADE 感知的数据。通过自我管理问卷和图表审查收集人口统计学、临床和 ADE 特征。使用回归分析分析这些因素与 ADE 感知之间的关系。
共有 261 名感知到 ADE 的 HF 患者完成了问卷调查。患者报告了 814 个 ADE，其中 26%的患者报告头晕，24%的患者报告口干是最常见的。近一半的患者（46%）认为他们的 ADE 很严重，对日常生活有重大影响（40%），并表示担心（36%）ADE。患者认为 ADE 是一个慢性问题（91%），大多数人更相信医疗保健提供者控制 ADE 的能力（61%），而不是他们自己的能力（46%）。在调整 ADE 特征（如感知严重程度）后，人口统计学和临床变量对 ADE 感知的解释方差贡献有限。
HF 患者感知到特定的不良反应事件的负面后果和情绪困扰。在决定 ADE 管理方案时，患者与提供者之间进行开诚布公的沟通，并关注患者对 ADE 的感知，这将是有价值的，可能会制定出符合患者偏好和需求的治疗方案。
