Ng Yew Keong, Shah Noraida Mohamed, Loong Ly Sia, Pee Lay Ting, Hidzir Sarina Anim M, Chong Wei Wen
Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Department of Pharmacy, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Patient Prefer Adherence. 2018 Apr 23;12:615-624. doi: 10.2147/PPA.S159113. eCollection 2018.
This study investigated patients' and pharmacists' attitudes toward concordance in a pharmacist-patient consultation and how patients' attitudes toward concordance relate to their involvement and self-efficacy in decision making associated with medication use.
A cross-sectional study was conducted among patients with chronic diseases and pharmacists from three public hospitals in Malaysia. The Revised United States Leeds Attitudes toward Concordance (RUS-LATCon) was used to measure attitudes toward concordance in both patients and pharmacists. Patients also rated their perceived level of involvement in decision making and completed the Decision Self-Efficacy scale. One-way analysis of variance (ANOVA) and independent -test were used to determine significant differences between different subgroups on attitudes toward concordance, and multiple linear regression was performed to find the predictors of patients' self-efficacy in decision making.
A total of 389 patients and 93 pharmacists participated in the study. Pharmacists and patients scored M=3.92 (SD=0.37) and M=3.84 (SD=0.46) on the RUS-LATCon scale, respectively. Seven items were found to be significantly different between pharmacists and patients on the subscale level. Patients who felt fully involved in decision making (M=3.94, SD=0.462) scored significantly higher on attitudes toward concordance than those who felt partially involved (M=3.82, SD=0.478) and not involved at all (M=3.68, SD=0.471; <0.001). Patients had an average score of 76.7% (SD=14.73%) on the Decision Self-Efficacy scale. In multiple linear regression analysis, ethnicity, number of medications taken by patients, patients' perceived level of involvement, and attitudes toward concordance are significant predictors of patients' self-efficacy in decision making (<0.05).
Patients who felt involved in their consultations had more positive attitudes toward concordance and higher confidence in making an informed decision. Further study is recommended on interventions involving pharmacists in supporting patients' involvement in medication-related decision making.
本研究调查了患者和药剂师在药剂师-患者咨询中对一致性的态度，以及患者对一致性的态度如何与他们在药物使用相关决策中的参与度和自我效能感相关。
在马来西亚三家公立医院的慢性病患者和药剂师中进行了一项横断面研究。修订后的美国利兹一致性态度量表（RUS-LATCon）用于测量患者和药剂师对一致性的态度。患者还对他们在决策中的感知参与程度进行评分，并完成决策自我效能量表。采用单因素方差分析（ANOVA）和独立样本t检验来确定不同亚组在一致性态度上的显著差异，并进行多元线性回归以找出患者决策自我效能感的预测因素。
共有389名患者和93名药剂师参与了研究。药剂师和患者在RUS-LATCon量表上的得分分别为M=3.92（标准差=0.37）和M=3.84（标准差=0.46）。在分量表水平上，发现药剂师和患者在七个项目上存在显著差异。认为完全参与决策的患者（M=3.94，标准差=0.462）在一致性态度上的得分显著高于认为部分参与的患者（M=3.82，标准差=0.478）和完全不参与的患者（M=3.68，标准差=0.471；P<0.001）。患者在决策自我效能量表上的平均得分为76.7%（标准差=14.73%）。在多元线性回归分析中，种族、患者服用的药物数量、患者感知的参与程度以及对一致性的态度是患者决策自我效能感的显著预测因素（P<0.05）。
认为参与了咨询的患者对一致性有更积极的态度，并且在做出明智决策方面有更高的信心。建议进一步研究涉及药剂师支持患者参与药物相关决策的干预措施。
