DiSantostefano Rachael L, Beck Melissa, Yeakey Anne M, Raphiou Ibrahim, Stempel David A
1 GlaxoSmithKline, Research Triangle Park, NC, USA.
2 Regulated Healthcare Market Research, Concentrics Research, Indianapolis, IN, USA.
Ther Innov Regul Sci. 2014 Sep;48(5):574-582. doi: 10.1177/2168479014524407.
This study assessed patients' comprehension of the Advair and Serevent medication guides (MGs) and MG reading behaviors with the goal to improve risk communication.
After reading their assigned MGs, 452 adults with asthma or chronic obstructive pulmonary disease participated in structured interviews to assess comprehension of safety risks in the Advair MG (asthma, n = 150; chronic obstructive pulmonary disease, n = 153) and Serevent MG (asthma, n = 149). Generalized estimating equations for correlated binary data were used to identify factors associated with correct responses.
For 10 of 12 individual risk questions, ≥75% of patients reported correct responses. After adjusting for patient characteristics, health literacy was significantly associated with correct responses (odds ratio = 1.03, 95% confidence interval = 1.02-1.05 per 1-point increase in the Rapid Estimate of Adult Literacy in Medicine). MG reading behaviors were inconsistent, with many patients reading MGs only once (40%) despite multiple prescriptions.
Comprehension of safety risks in the Advair and Serevent MGs was adequate for most patients in the study but decreased with health literacy. Initiatives to improve patient-directed risk communication should consider health literacy and reasons for inconsistent reading behaviors.
本研究评估了患者对氟替卡松/沙美特罗吸入剂(Advair)和沙美特罗(Serevent)用药指南(MGs)的理解以及MGs阅读行为,旨在改善风险沟通。
452名患有哮喘或慢性阻塞性肺疾病的成年人阅读其指定的MGs后,参与结构化访谈,以评估对Advair MG(哮喘,n = 150;慢性阻塞性肺疾病,n = 153)和Serevent MG(哮喘,n = 149)中安全风险的理解。使用相关二元数据的广义估计方程来确定与正确回答相关的因素。
对于12个个体风险问题中的10个,≥75%的患者报告了正确回答。在对患者特征进行调整后,健康素养与正确回答显著相关(优势比 = 1.03,95%置信区间 = 每医学成人识字快速评估增加1分,1.02 - 1.05)。MG阅读行为不一致,尽管有多次处方,但许多患者仅阅读一次MGs(40%)。
在本研究中,大多数患者对Advair和Serevent MGs中安全风险的理解是足够的,但随着健康素养的降低而下降。改善以患者为导向的风险沟通的举措应考虑健康素养和阅读行为不一致的原因。