Cañamares Orbis Irene, Saez de la Fuente Javier, Izquierdo García Elsa, Esteban Alba Concepción, Such Díaz Ana, Escobar Rodríguez Ismael
Servicio de Farmacia. Hospital Universitario Infanta Leonor. Madrid. España.
Farm Hosp. 2016 Nov 1;40(n06):569-578. doi: 10.7399/fh.2016.40.6.10503.
To learn about and analyze the self-reported treatment experience of HCV patients who started treatment with direct acting antivirals agents (DAA), at a real-time, proactive and integrated into the pharmaceutical care healthcare process, using a prospective questionnaire completed by patients as clinical tool.
Observational and cross-sectional study conducted between April (start of the National Strategic Plan) and December 2015 in the Outpatient Pharmacy Service. The questionnaire includes variables related to health related quality of life (HRQOL), adherence, adverse effects (AEs), satisfaction, and usefulness of the Pharmacy Service implemented training program. A descriptive analysis of all variables included in the study was conducted and the influence of different variables analyzed in the degree of adherence and HRQOL. The analysis of the differences was performed using chi-square test and simple logistic regression model for calculation of OR. We use SPSS version 20 program and statistical significance for values of p < 0.05 was considered.
155 of the 226 surveys returned, with a response rate of 68.6%. Referring to the HRQOL (evaluation of physical and emotional state), 38.7% of patients reports that their physical and emotional state is much better from the start of treatment. The presence of EA and worse global information of their disease was associated with worse physical and emotional state (p < 0.05). Reported adherence was 84.5% and the treatment was evaluated as very good or good by 87% of patients. 52.9% had no adverse effects related to the medication and the training process performed by the specialist pharmacist at the first visit 96.7% of patients assessed as very good or good.
Self-reported experience acquired through direct and constant contact with patients provides information on important aspects of treatment. We believe that these tools should be incorporated into pharmaceutical care procedures as a way to maintain continuity in patients direct contact. They also induce patients to a self-assessment of various aspects of their own treatment, which can help achieve greater involvement in it and can contribute to achieve the maximum health outcome in pharmacotherapy.
通过患者填写前瞻性问卷这一临床工具,以实时、主动且融入药学服务医疗过程的方式,了解并分析开始使用直接抗病毒药物(DAA)治疗的丙型肝炎病毒(HCV)患者的自我报告治疗经历。
于2015年4月(国家战略计划启动时)至12月在门诊药房服务处开展观察性横断面研究。问卷包含与健康相关生活质量(HRQOL)、依从性、不良反应(AE)、满意度以及所实施培训项目的药房服务有用性相关的变量。对研究中包含的所有变量进行描述性分析,并分析不同变量对依从程度和HRQOL的影响。使用卡方检验和简单逻辑回归模型进行差异分析以计算比值比(OR)。我们使用SPSS 20版程序,p < 0.05的值被视为具有统计学意义。
226份调查问卷中回收了155份,回复率为68.6%。关于HRQOL(身体和情绪状态评估),38.7%的患者报告自治疗开始以来其身体和情绪状态有很大改善。出现AE以及对自身疾病的总体了解较差与较差的身体和情绪状态相关(p < 0.05)。报告的依从率为84.5%,87%的患者对治疗评价为非常好或好。52.9%的患者没有与药物相关的不良反应,首次就诊时专科药剂师进行的培训过程被96.7%的患者评价为非常好或好。
通过与患者直接持续接触获得的自我报告经历提供了关于治疗重要方面的信息。我们认为这些工具应纳入药学服务程序,作为保持与患者直接接触连续性的一种方式。它们还促使患者对自身治疗的各个方面进行自我评估,这有助于患者更多地参与治疗,并有助于在药物治疗中实现最大的健康效果。