Gebreyohannes Eyob Alemayehu, Bhagavathula Akshaya Srikanth, Abegaz Tadesse Melaku, Abebe Tamrat Befekadu, Belachew Sewunet Admasu, Tegegn Henok Getachew, Mansoor Sarab M
Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia,
Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
HIV AIDS (Auckl). 2019 Jan 14;11:9-16. doi: 10.2147/HIV.S186797. eCollection 2019.
In health communication, pictogram has a comprehensive place to aid attention, memory recall, and promote adherence. This study was conducted to assess whether pictorial intervention would help to identify and improve adverse drug reactions (ADRs) reporting in an antiretroviral therapy (ART) clinic in Northwest Ethiopia.
A cross-sectional study on ART-naïve HIV-positive patients was conducted from July 2015 to January 2016. The patients were randomly categorized into two groups. Group A was subjected to receive pictorial medication information and a pictogram-enhanced tool to identify and report ADRs, while group B did not receive any pictogram-enhanced tool.
A total of 207 ART-naïve HIV-positive patients who were registered for the ART treatment attending Gondar University Hospital ART clinic were included. Bivariate analysis showed that sociodemographic characteristics, such as age, sex, education, employment, and marital status were the main predictors of identifying and reporting ADRs. Males were twice more likely to identify ADRs than females. Univariate analysis revealed that patients assigned to group A showed a significant association with the ability to identify ART medications using pictograms. Patients assigned to group A were more likely to identify lamivudine (OR [95% CI] =7.536 [4.042-14.021], ≤0.001), tenofovir (OR [95% CI] =6.250 [2.855-13.682], ≤0.001), nevirapine (OR [95% CI] =5.320 [1.954-14.484], =0.001), efavirenz (OR [95% CI] =3.929 [1.876-8.228], ≤0.001), and zidovudine (OR [95% CI] =3.570 [1.602-7.960], =0.002) using pictograms. Patients in group A were 4.3 times more likely to identify diarrhea as an ADR using pictogram compared with group B.
The use of pictorial representation resulted in only slight improvement in identification and reporting of ADRs among naïve HIV-positive patients with limited literacy in Northwest Ethiopia. This representation of ADRs merits further investigation with regard to ADR identification and promoting patients' safety, particularly for HIV-positive patients with limited educational levels.
在健康传播中，象形图在吸引注意力、唤起记忆以及促进依从性方面具有全面的作用。本研究旨在评估图片干预是否有助于识别和改善埃塞俄比亚西北部一家抗逆转录病毒治疗（ART）诊所的药物不良反应（ADR）报告情况。
2015年7月至2016年1月，对未接受过ART治疗的HIV阳性患者进行了一项横断面研究。患者被随机分为两组。A组接受图片用药信息和用于识别及报告ADR的象形图增强工具，而B组未接受任何象形图增强工具。
共有207名在贡德尔大学医院ART诊所登记接受ART治疗的未接受过ART治疗的HIV阳性患者被纳入研究。双变量分析表明，年龄、性别、教育程度、就业情况和婚姻状况等社会人口学特征是识别和报告ADR的主要预测因素。男性识别ADR的可能性是女性的两倍。单变量分析显示，A组患者使用象形图识别ART药物的能力有显著关联。A组患者使用象形图识别拉米夫定（OR [95% CI] =7.536 [4.042 - 14.021]，≤0.001）、替诺福韦（OR [95% CI] =6.250 [2.855 - 13.682]，≤0.001）、奈韦拉平（OR [95% CI] =5.320 [1.954 - 14.484]，=0.001）、依非韦伦（OR [95% CI] =3.929 [1.876 - 8.228]，≤0.001）和齐多夫定（OR [95% CI] =3.570 [1.602 - 7.960]，=0.002）的可能性更高。与B组相比，A组患者使用象形图将腹泻识别为ADR的可能性高4.3倍。
在埃塞俄比亚西北部识字能力有限的未接受过治疗的HIV阳性患者中，使用图片表示法在ADR的识别和报告方面仅带来了轻微改善。关于ADR识别和促进患者安全，尤其是对于教育水平有限的HIV阳性患者，这种ADR表示法值得进一步研究。
