a Department of Emergency Medicine, and the Health Literacy and Learning Program, Division of General Internal Medicine, Feinberg School of Medicine , Northwestern University , Chicago , Illinois , USA.
J Health Commun. 2013;18 Suppl 1(Suppl 1):40-8. doi: 10.1080/10810730.2013.825675.
Recent studies have linked patient misunderstanding of label instructions for as needed (PRN) medications to dosing errors. This study conducted a preliminary field test of patient-centered PRN label instructions. Patients participated in a hypothetical dosing experiment and were randomized to a patient-centered label (referred to as "Take-Wait-Stop") or standard label. Participants were asked to demonstrate dosing the medicine over 24 hours. Three types of independent dosing errors were measured: (a) taking more than two pills at one time, (b) exceeding the maximum daily dose, and (c) waiting fewer than 4 hours between doses. Generalized linear models were used to assess the association between label type, health literacy, and sociodemographic characteristics. Participants' mean age was 39.8 years, 62.1% were female, 43.7% were White, and 72.4% had adequate literacy. Of participants, 31.8% who were shown the standard label demonstrated taking in excess of 6 pills in 24 hours compared with only 14.0% of participants who were shown the Take-Wait-Stop label (p = .05). Overall, only 1 person demonstrated he would take more than 2 pills in a single dose. Of the standard label group, 20.5% demonstrated dosing intervals of fewer than 4 hours compared with 23.3% of the Take-Wait-Stop label group (p=.75). In a multivariate model, participants who were exposed to the standard label were 2.5 times more likely to exceed the recommended maximum daily dose (95% CI [1.05, 7.70], p=.03). The Take-Wait-Stop label was beneficial in preventing participants from exceeding the maximum dose in 24 hours, although it did not significantly reduce other dosing errors.
最近的研究将患者对按需（PRN）药物标签说明的误解与用药错误联系起来。本研究对以患者为中心的 PRN 标签说明进行了初步现场测试。患者参与了一个假设的给药实验，并被随机分配到以患者为中心的标签（称为“Take-Wait-Stop”）或标准标签。参与者被要求在 24 小时内演示给药。测量了三种独立的给药错误：（a）一次服用超过两片，（b）超过每日最大剂量，（c）两次服药之间等待时间少于 4 小时。使用广义线性模型评估标签类型、健康素养和社会人口统计学特征之间的关联。参与者的平均年龄为 39.8 岁，62.1%为女性，43.7%为白人，72.4%具有足够的读写能力。与展示标准标签的参与者相比，31.8%展示标准标签的参与者在 24 小时内服用超过 6 片的比例仅为 14.0%（p=0.05）。总体而言，只有 1 人表示他会单次服用超过 2 片。在标准标签组中，有 20.5%的人给药间隔少于 4 小时，而在 Take-Wait-Stop 标签组中，这一比例为 23.3%（p=0.75）。在多变量模型中，暴露于标准标签的参与者超过推荐最大每日剂量的可能性是 2.5 倍（95%CI[1.05，7.70]，p=0.03）。虽然 Take-Wait-Stop 标签并没有显著减少其他剂量错误，但它有助于防止参与者在 24 小时内超过最大剂量。
