Herxheimer Andrew
UK Cochrane Centre, 9 Park Crescent, London N3 2NL, UK.
Br J Clin Pharmacol. 2012 Jun;73(6):943-7. doi: 10.1111/j.1365-2125.2012.04243.x.
Knowing some basic principles about medicines would help patients to understand drug therapy and to help and encourage them to use it well. These principles relate to the categories and names of drugs, their different uses, how they reach the site of action (absorption, distribution, fate), how they produce their effects, both beneficial and harmful, the time courses of drug actions, how the pattern and intensity of the effects of a drug depend on dose and timing, drug interactions, how drug effects are demonstrated and investigated and sources of information and their trustworthiness. These basic principles are an essential part of health literacy and understanding them would enable individuals to comprehend better the information that they are likely to receive about medicines that they will take. Different populations need different types of education. For schoolchildren, the principles could fit into biology and domestic science teaching, starting in the later years of primary school or early in secondary school. A teaching package would also be needed for their teachers. For adults, web-based learning seems the most practical option. Web-based programmes could be supported by the NHS and professional bodies and through public libraries and local community health services. Specific groups for targeting could include young mothers and carers of chronically ill people. For retired people, one could envisage special programmes, perhaps in collaboration with the University of the Third Age. Conversations between patients and professionals would then become more effective and help shared decision making.
了解一些关于药物的基本原理将有助于患者理解药物治疗,并帮助和鼓励他们合理用药。这些原理涉及药物的类别和名称、不同用途、药物到达作用部位的方式(吸收、分布、转归)、药物产生有益和有害作用的机制、药物作用的时间过程、药物作用的模式和强度如何取决于剂量和给药时间、药物相互作用、药物作用如何被证实和研究以及信息来源及其可信度。这些基本原理是健康素养的重要组成部分,理解它们能使个人更好地理解他们可能收到的关于所服用药物的信息。不同人群需要不同类型的教育。对于学童来说,这些原理可以融入小学高年级或初中早期的生物和家政学教学中。还需要为他们的教师提供一套教学资料。对于成年人来说,基于网络的学习似乎是最实际的选择。基于网络的课程可以得到英国国家医疗服务体系(NHS)和专业机构的支持,并通过公共图书馆和当地社区卫生服务机构来实施。有针对性的特定群体可以包括年轻母亲和慢性病患者的护理人员。对于退休人员,可以设想开展一些特别项目,或许可以与第三年龄大学合作。这样患者与专业人员之间的沟通将更有效,并有助于共同决策。