格式对慢性病依从性数据理解的影响：一项关于艾滋病的横断面研究。
Effect of format on comprehension of adherence data in chronic disease: A cross-sectional study in HIV.
作者信息
Lyons Anita, Bilker Warren B, Hines Janet, Gross Robert
机构信息
Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, PA, United States.
Department of Medicine (Infectious Diseases), Perelman School of Medicine, University of Pennsylvania, PA, United States.
出版信息
Patient Educ Couns. 2016 Jan;99(1):154-9. doi: 10.1016/j.pec.2015.08.002. Epub 2015 Aug 4.
OBJECTIVE
To determine which formats communicate medication adherence effectively to patients.
METHODS
HIV-infected adults on antiretrovirals viewed examples of refill data in 5 formats: (1) percentage of doses, (2) number of days late to refill ("days late"), (3) calendar of days with/without medications, (4) pie chart of days with/without medications, and (5) letter grade. Five scenarios (>95%, 90-95%, <90%, <80% and <70% adherence) were presented in each format. Participants rated scenarios on adherence improvement needed. "Good understanding" was ≥ 4 of 5 scenarios correct. We calculated odds ratios for "good understanding" using logistic regression with percentage as the referent format.
RESULTS
124 participants were median age 48.5 years, 65% Black, 71% male. Understanding of all formats differed by education (all interaction p values<0.02). For ≤ 12 years education, odds ratios (OR) of understanding (95% CI) compared to percentage were: days late 3.3 (2.3-4.7), calendar 3.1 (2.2-4.3) pie chart 2.0 (1.4-2.7), and letter grade 1.8 (1.3-2.5). For >12 years education, ORs were: days late 1.3 (0.9-2.0), calendar 2.4 (1.5-3.8), pie chart 2.9 (1.8-4.6), and letter grade 1.7 (1.1-2.6). Calendar plot was most preferred.
CONCLUSIONS
Adherence percentage was the least understood format regardless of education.
PRACTICE IMPLICATIONS
Calendars should be used to convey adherence information.
目的
确定哪种形式能有效地向患者传达药物依从性。
方法
接受抗逆转录病毒治疗的HIV感染成人观看了5种形式的续方数据示例：（1）服药剂量百分比，（2）续方延迟天数（“延迟天数”），（3）有/无药物服用的日历，（4）有/无药物服用的饼状图，以及（5）字母等级。每种形式呈现了5种情况（依从性>95%、90 - 95%、<90%、<80%和<70%）。参与者对需要改善依从性的情况进行评分。“良好理解”定义为5种情况中至少答对4种。我们使用逻辑回归计算“良好理解”的优势比，以百分比形式作为参照形式。
结果
124名参与者的年龄中位数为48.5岁，65%为黑人，71%为男性。对所有形式的理解因教育程度而异（所有交互p值<0.02）。对于受教育年限≤12年的参与者，与百分比形式相比，理解的优势比（OR）（95%置信区间）为：延迟天数3.3（2.3 - 4.7），日历3.1（2.2 - 4.3），饼状图2.0（1.4 - 2.7），字母等级1.8（1.3 - 2.5）。对于受教育年限>12年的参与者，OR分别为：延迟天数1.3（0.9 - 2.0），日历2.4（1.5 - 3.8），饼状图2.9（1.8 - 4.6），字母等级1.7（1.1 - 2.6）。日历图最受青睐。
结论
无论教育程度如何，依从性百分比是最不易理解的形式。
实践意义
应使用日历来传达依从性信息。
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