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评估患者对标准化用药计划的理解程度。

Evaluating patients' comprehensibility of a standardized medication plan.

作者信息

Botermann Lea, Monzel Katharina, Krueger Katrin, Eickhoff Christiane, Wachter Angelika, Kloft Charlotte, Laufs Ulrich, Schulz Martin

机构信息

Department of Medicine, ABDA-Federal Union of German Associations of Pharmacists, Unter den Linden 19-23, 10117, Berlin, Germany.

Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Freie Universitaet Berlin, Berlin, Germany.

出版信息

Eur J Clin Pharmacol. 2016 Oct;72(10):1229-1237. doi: 10.1007/s00228-016-2082-5. Epub 2016 Jun 15.

Abstract

PURPOSE

A standardized medication plan for patients has been developed and recently enacted into German law depicting all medicines taken. It can only increase medication safety if patients use and understand it. We evaluated patients' comprehensibility of the medication plan and analyzed potential variables influencing patients' understanding.

METHODS

The medication plan template v2.0 was first tested in N = 40 patients, and the "Evaluation Tool to test the handling of the Medication Plan" (ET-MP) was developed, rating patients' understanding from 0 to 100 %. The cut-off, distinguishing if patients understand the medication plan, was set at 90 %. The ET-MP was then applied to an amended medication plan questioning N = 40 general internal medicine (GIM) and N = 50 patients with chronic heart failure (CHF).

RESULTS

The mean (± standard deviation (SD)) age of the study cohort was 69 ± 13 years, 47 % female. Patients took 8 ± 3 drugs chronically. The CHF patients had a lower level of education compared to the GIM group (p = 0.004). The overall ET-MP score was 82 ± 21 % (GIM 86 ± 19 %, CHF 78 ± 23 %; p = 0.16). Forty-three percent achieved a score >90 %. A moderate correlation was found between the ET-MP score and the level of education (r = 0.45) and age (r = -0.46), respectively (both p < 0.001). Cognitively impaired CHF patients (p = 0.03) and patients with advanced CHF (p = 0.006) achieved a lower ET-MP score. In the CHF cohort, signs of depression or a lower level of self-care behaviour were not associated with a lower ET-MP score.

CONCLUSION

The ET-MP is suitable to explore patients' understanding of a medication plan. Less than 50 % of the patients reached a score above 90 %. Higher age and lower level of education but not the diagnosis of CHF seem to correlate with impaired understanding of the standardized medication plan. In addition to a medication plan, a significant number of patients are in need of further and continuous care to improve medication safety.

摘要

目的

已为患者制定了一份标准化用药计划,该计划最近被纳入德国法律,涵盖了患者服用的所有药物。只有当患者使用并理解该计划时,才能提高用药安全性。我们评估了患者对用药计划的理解程度,并分析了影响患者理解的潜在变量。

方法

用药计划模板v2.0首先在N = 40名患者中进行测试,并开发了“用药计划操作测试评估工具”(ET-MP),对患者的理解程度从0到100%进行评分。区分患者是否理解用药计划的临界值设定为90%。然后将ET-MP应用于一份修订后的用药计划,对N = 40名普通内科(GIM)患者和N = 50名慢性心力衰竭(CHF)患者进行询问调查。

结果

研究队列的平均(±标准差(SD))年龄为69±13岁,女性占47%。患者长期服用8±3种药物。与GIM组相比,CHF患者的教育程度较低(p = 0.004)。ET-MP的总体得分为82±21%(GIM组为86±19%,CHF组为78±23%;p = 0.16)。43%的患者得分>90%。ET-MP得分与教育程度(r = 0.45)和年龄(r = -0.46)之间分别存在中度相关性(两者p均<0.001)。认知受损的CHF患者(p = 0.03)和晚期CHF患者(p = 0.006)的ET-MP得分较低。在CHF队列中,抑郁迹象或较低水平的自我护理行为与较低的ET-MP得分无关。

结论

ET-MP适用于探究患者对用药计划的理解。不到50%的患者得分高于90%。年龄较大和教育程度较低似乎与对标准化用药计划理解受损相关,但CHF的诊断并非如此。除了用药计划外,大量患者还需要进一步的持续护理以提高用药安全性。

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