Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Punjab, Pakistan.
School of Management, Massey University, Auckland, New Zealand.
PLoS One. 2018 Jun 1;13(6):e0197482. doi: 10.1371/journal.pone.0197482. eCollection 2018.
Patients' knowledge about their prescribed medicines is one of the most important antecedents of successful therapy. Poor knowledge about medicines can lead to serious consequences such as non-adherence and misunderstanding of the significance of adverse events. The objective of this study is to understand the factors that are responsible for a patients' lack of knowledge regarding their medicines, by taking the perspective of the patient as well as that of healthcare professionals. Much of the work in this area has been undertaken in the setting of developed or semi-developed countries, and there is a scarcity of information from developing nations such as Pakistan.
This was a large qualitative study set in the hospital outpatient environment in a teaching hospital in the Punjab province of Pakistan. Data were collected from dialogue with patients (n = 19) and healthcare providers (n = 16) i.e., doctors and dispensers (where a dispenser is a person who merely dispenses medicines; i.e. is not a pharmacist) through in-depth semi-structured interviews. Patients having limited knowledge about their dispensed medicines were assessed using a checklist. The healthcare providers were recruited through a convenience sampling strategy, based on their availability and willingness to participate in the study. Based on the objectives of the study, a pilot tested interview protocol was developed, and used to conduct the interviews. The sample size was controlled by using saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analyzed to draw conclusions using inductive thematic content analysis.
The analysis of data yielded 31 categories (patients = 19, healthcare professionals = 12), 10 subthemes and three themes. The major themes were healthcare professional-related factors, patient-related factors and system-related factors. The health professional related subthemes included: behaviour and attitude and professional liabilities and liaison. The patient related subthemes included: eagerness of the patients and lack of understanding and misconception. The system-related factors included: patients with special needs, perceived role of the pharmacist, prescription and medicines, and staff workload.
Healthcare professional related, patient related and system related factors have a significant influence on patients' knowledge about dispensed medicines. The non-professional behaviour of doctors, increased staff workload, inadequate time and attention provided by healthcare professionals to patients, illiteracy of patients, lack of specialized labelling on medicines for illiterate patients and absence of pharmacists at the hospital, were the major concerns identified in this study. The study points to a need for appropriate patient education and counselling with regards medicines, improved coordination between hospital staff, and provision of some basic system-related facilities which are pivotal for enhancing patients' knowledge and adherence to their treatment regimens.
患者对其所服用药物的了解是成功治疗的最重要前提之一。对药物的了解不足可能会导致严重后果，如不遵医嘱和对不良反应的重要性产生误解。本研究的目的是从患者和医疗保健专业人员的角度了解导致患者对药物缺乏了解的因素。这方面的大部分工作都是在发达国家或半发达国家进行的，而来自巴基斯坦等发展中国家的信息却很少。
这是一项在巴基斯坦旁遮普省一所教学医院的门诊环境中进行的大型定性研究。通过与患者（n=19）和医疗保健提供者（n=16），即医生和药剂师（药剂师仅分发药物；即不是药剂师）进行深入的半结构化访谈来收集数据。使用清单评估对所分发药物了解有限的患者。根据他们的可用性和参与研究的意愿，通过便利抽样策略招募医疗保健提供者。根据研究目的，使用经过试验测试的访谈协议进行访谈。使用饱和度标准控制样本量。所有访谈均进行录音并逐字记录。使用归纳主题内容分析来分析数据以得出结论。
数据分析产生了 31 个类别（患者=19，医疗保健专业人员=12），10 个子主题和 3 个主题。主要主题是医疗保健专业人员相关因素、患者相关因素和系统相关因素。与医疗保健专业人员相关的子主题包括：行为和态度以及专业责任和联络。与患者相关的子主题包括：患者的积极性、缺乏理解和误解。系统相关因素包括：有特殊需求的患者、药剂师的感知角色、处方和药物以及员工工作量。
医疗保健专业人员相关、患者相关和系统相关因素对患者对所分发药物的了解有重大影响。医生的非专业行为、工作人员工作量增加、医疗保健专业人员为患者提供的时间和关注不足、患者的文盲、文盲患者的药物缺乏专门标签以及医院缺乏药剂师，是本研究中发现的主要问题。该研究表明，需要对药物进行适当的患者教育和咨询，改善医院工作人员之间的协调，并提供一些增强患者知识和坚持治疗方案的基本系统相关设施。
