Utrecht Pharmacy Practice Network for Education and Research (UPPER), Utrecht University, The Netherlands.
Utrecht Pharmacy Practice Network for Education and Research (UPPER), Utrecht University, The Netherlands.
Res Social Adm Pharm. 2018 Sep;14(9):812-816. doi: 10.1016/j.sapharm.2018.01.009. Epub 2018 Feb 3.
Patients with limited pharmaceutical literacy are at increased risk of drug-related problems. Recognizing these patients in daily practice is difficult. The Recognition and Addressing of Limited Pharmaceutical Literacy (RALPH) interview guide was developed as practical set of questions to recognize patients with limited pharmaceutical literacy in daily pharmacy practice.
To compare agreement between pharmaceutical literacy measured with the RALPH guide and a validated general health literacy questionnaire. In addition, we provide insight into patients' pharmaceutical literacy using the RALPH interview guide.
Structured face-to-face interviews with patients who visited a community pharmacy to fill a prescription for themselves were conducted. The interview included the RALPH guide as well as the Functional Communicative Critical Health Literacy (FCCHL) questionnaire to measure general health literacy. Functional, communicative and critical skills were measured and agreement between two methods was calculated.
Data were collected from 508 patients. Patients with limited pharmaceutical literacy, indicated by the RALPH questions, also had a lower general health literacy level according to FCCHL scores. Agreement between the RALPH guide and FCCHL questionnaire was moderate (∼60%) for the three health literacy domains. Most patients (>90%) had correct understanding of frequency and timing of medication use, but 25% did not understand warnings or precautions correctly. Finding understandable information (39%), assessing information applicability (50%) and reliability (64%) were mentioned as difficult by patients.
Patients experienced difficulties with more complex skills, e.g. interpretation of warnings or precautions when using a medicine, finding and analyzing medication information. Whereas the FCCHL questionnaire is useful to assess general health literacy, the RALPH interview guide provides insight in the level of skills needed for good medication use and is more suitable for use in a medication specific context such as community pharmacy. Context specific assessment of skills is important to provide tailored pharmaceutical care.
药物知识有限的患者发生药物相关问题的风险增加。在日常实践中识别这些患者具有一定难度。识别和处理有限药物知识（RALPH）访谈指南是作为一套实用的问题集开发的，旨在识别日常药房实践中药物知识有限的患者。
比较 RALPH 指南测量的药物知识与经过验证的一般健康知识问卷之间的一致性。此外，我们还使用 RALPH 访谈指南深入了解患者的药物知识。
对前往社区药房自行配药的患者进行了结构化的面对面访谈。访谈包括 RALPH 指南和功能性交流关键健康知识问卷（FCCHL），以衡量一般健康知识水平。测量了功能性、交流性和批判性技能，并计算了两种方法之间的一致性。
共收集了 508 名患者的数据。根据 RALPH 问题，药物知识有限的患者根据 FCCHL 评分，其一般健康知识水平也较低。RALPH 指南和 FCCHL 问卷在三个健康知识领域的一致性为中等（约 60%）。大多数患者（>90%）对药物使用的频率和时间有正确的理解，但 25%的患者对警告或注意事项理解不正确。患者认为找到易懂的信息（39%）、评估信息适用性（50%）和可靠性（64%）较为困难。
患者在更复杂的技能方面存在困难，例如在使用药物时解释警告或注意事项、查找和分析药物信息。虽然 FCCHL 问卷可用于评估一般健康知识，但 RALPH 访谈指南深入了解了良好用药所需的技能水平，更适合在社区药房等药物特定环境中使用。对技能的特定于上下文的评估对于提供定制的药物护理很重要。
