Sinayev Aleksandr, Peters Ellen, Tusler Martin, Fraenkel Liana
Ohio State University, Columbus, OH (AS, EP, MT)
Yale School of Medicine, New Haven, CT (LF).
Med Decis Making. 2015 Nov;35(8):937-47. doi: 10.1177/0272989X15584922. Epub 2015 May 7.
Previous research demonstrated that providing (v. not providing) numeric information about the adverse effects (AEs) of medications increased comprehension and willingness to use medication but left open the question about which numeric format is best. The objective was to determine which of 4 tested formats (percentage, frequency, percentage + risk label, frequency + risk label) maximizes comprehension and willingness to use medication across age and numeracy levels.
In a cross-sectional internet survey (N = 368; American Life Panel, 15 May 2008 to 18 June 2008), respondents were presented with a hypothetical prescription medication for high cholesterol. AE likelihoods were described using 1 of 4 tested formats. Main outcome measures were risk comprehension (ability to identify AE likelihood from a table) and willingness to use the medication (7-point scale; not likely = 0, very likely = 6).
The percentage + risk label format resulted in the highest comprehension and willingness to use the medication compared with the other 3 formats (mean comprehension in percentage + risk label format = 95% v. mean across the other 3 formats = 81%; mean willingness = 3.3 v. 2.95, respectively). Comprehension differences between percentage and frequency formats were smaller among the less numerate. Willingness to use medication depended less on age and numeracy when labels were used. Generalizability is limited by the use of a sample that was older, more educated, and better off financially than national averages.
Providing numeric AE-likelihood information in a percentage format with risk labels is likely to increase risk comprehension and willingness to use a medication compared with other numeric formats.
先前的研究表明,提供(而非不提供)药物不良反应(AE)的数字信息可提高理解能力和用药意愿,但哪种数字格式最佳的问题仍未解决。目的是确定四种测试格式(百分比、频率、百分比 + 风险标签、频率 + 风险标签)中的哪一种能在不同年龄和算术水平上最大限度地提高理解能力和用药意愿。
在一项横断面网络调查(N = 368;美国生活面板,2008年5月15日至2008年6月18日)中,向受访者展示了一种用于治疗高胆固醇的假设处方药。使用四种测试格式之一描述AE可能性。主要结局指标是风险理解(从表格中识别AE可能性的能力)和用药意愿(7分制;不太可能 = 0,非常可能 = 6)。
与其他三种格式相比,百分比 + 风险标签格式的理解能力和用药意愿最高(百分比 + 风险标签格式的平均理解率 = 95%,其他三种格式的平均理解率 = 81%;平均意愿分别为3.3和2.95)。在算术能力较低的人群中,百分比和频率格式之间的理解差异较小。使用标签时,用药意愿对年龄和算术能力的依赖性较小。由于使用的样本比全国平均水平年龄更大、受教育程度更高且经济状况更好,因此普遍性受到限制。
与其他数字格式相比,以百分比格式提供带有风险标签的数字AE可能性信息可能会提高风险理解能力和用药意愿。