Mullen Rebecca J, Curtis Laura M, O'Conor Rachel, Serper Marina, McCarthy Danielle, Bailey Stacy C, Parker Ruth M, Wolf Michael S
Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Am J Health Syst Pharm. 2018 May 1;75(9):e213-e220. doi: 10.2146/ajhp170303.
Results of a study of associations between visual acuity and the risk of misuse of nonprescription acetaminophen products in a sample of community-dwelling adults are reported.
In a study involving English-speaking adults at 4 primary care clinics, the potential for misuse of nonprescription acetaminophen products was measured via a functional assessment of product self-dosing and by testing patients' understanding of the risks of concomitant use (i.e., taking 2 products at the same time when contraindicated). Vision was assessed using the Rosenbaum vision chart and dichotomized as normal (visual acuity of 20/20-20/25) or low (acuity of 20/30-20/100). Bivariable and multivariable analyses were performed to determine the impact of visual acuity on medication misuse outcomes.
Among the study participants ( = 500), 39% had limited literacy, and 54% were categorized as having low vision. After controlling for age, race, and prior acetaminophen use, low vision was independently associated with an increased risk of self-dosing errors (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.25-2.21; < 0.001) and misunderstanding of concomitant-use risks (OR, 1.41; 95% CI, 1.00-2.00; = 0.05). Limited literacy was an independent risk factor for incorrect dosing (OR, 1.71; 95% CI, 1.25-2.35; = 0.001) and unawareness of concomitant use instructions (OR, 4.14; 95% CI, 2.80-6.12; < 0.001).
Misunderstanding of nonprescription acetaminophen product information was common among study participants and independently associated with both impaired visual acuity and low literacy skills.
报告一项关于社区居住成年人样本中视力与非处方对乙酰氨基酚产品误用风险之间关联的研究结果。
在一项涉及4家初级保健诊所中讲英语成年人的研究中，通过对产品自我给药的功能评估以及测试患者对同时使用风险（即在禁忌时同时服用两种产品）的理解来衡量非处方对乙酰氨基酚产品的误用可能性。使用罗森鲍姆视力表评估视力，并将其分为正常（视力为20/20 - 20/25）或低视力（视力为20/30 - 20/100）。进行双变量和多变量分析以确定视力对药物误用结果的影响。
在研究参与者（n = 500）中，39%的人识字能力有限，54%的人被归类为低视力。在控制年龄、种族和既往对乙酰氨基酚使用情况后，低视力与自我给药错误风险增加独立相关（优势比[OR]，1.67；95%置信区间[CI]，1.25 - 2.21；P < 0.001）以及对同时使用风险的误解（OR，1.41；95% CI，1.00 - 2.00；P = 0.05）。识字能力有限是剂量错误（OR，1.71；95% CI，1.25 - 2.35；P = 0.001）和不了解同时使用说明（OR，4.14；95% CI，2.80 - 6.12；P < 0.001）的独立危险因素。
研究参与者中对非处方对乙酰氨基酚产品信息的误解很常见，并且与视力受损和识字技能低均独立相关。
