Bailey Stacy Cooper, Wolf Michael S, Lopez Andrea, Russell Allison, Chen Alice Hm, Schillinger Dean, Moy Glen, Sarkar Urmimala
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA.
BMJ Open. 2014 Jan 10;4(1):e003699. doi: 10.1136/bmjopen-2013-003699.
Improved drug labelling for chronic pill-form medications has been shown to promote patient comprehension, adherence and safety. We extended health literacy principles and included patients' perspectives to improve instructions for: (1) non-pill form, (2) short term, (3) 'as needed,' (4) tapered and (5) escalating dose medications.
Participants were recruited via convenience sampling from primary care clinics in Chicago, Illinois and San Francisco, California, USA.
40 adult, English-speaking participants who reported taking at least one prescription drug in the past 12 months were enrolled in the study.
Participant opinions, preferences and comprehension of standard and improved medication instructions were assessed during four iterative waves of discussion groups. Brief interviews preceding the discussion groups measured individuals' literacy skills, sociodemographic and health characteristics.
On average, participants were 46 years old, took four medications and reported two chronic health conditions. Patients varied sociodemographically; 40% were men and 33% had limited literacy skills. Patients agreed on the need for simpler terminology and specificity in instructions. Discussions addressed optimal ways of presenting numeric information, indication and duration of use information to promote comprehension and safe medication use. Consensus was reached on how to improve most of the instructions.
Through this patient-centred approach, we developed a set of health literacy-informed instructions for more challenging medications. Findings can inform current drug labelling initiatives and promote safe and appropriate medication use.
已证明改进慢性丸剂药物的药品标签可提高患者的理解度、依从性和安全性。我们扩展了健康素养原则，并纳入患者的观点，以改进以下几类药物的用药说明：（1）非丸剂形式，（2）短期用药，（3）“按需”用药，（4）逐渐减量用药，以及（5）递增剂量用药。
通过便利抽样从美国伊利诺伊州芝加哥市和加利福尼亚州旧金山市的初级保健诊所招募参与者。
40名成年英语使用者，他们报告在过去12个月中至少服用过一种处方药，被纳入该研究。
在四轮迭代的讨论小组中评估参与者对标准和改进后的用药说明的意见、偏好和理解。在讨论小组之前进行的简短访谈测量了个体的识字技能、社会人口统计学和健康特征。
参与者平均年龄为46岁，服用四种药物，并报告有两种慢性健康状况。患者在社会人口统计学方面存在差异；40%为男性，33%识字技能有限。患者一致认为用药说明需要更简单的术语和明确性。讨论涉及呈现数字信息、适应证和用药持续时间信息以促进理解和安全用药的最佳方式。就如何改进大多数用药说明达成了共识。
通过这种以患者为中心的方法，我们为更具挑战性的药物制定了一套基于健康素养的用药说明。研究结果可为当前的药品标签倡议提供参考，并促进安全、合理用药。
