J Am Pharm Assoc (2003). 2019 May-Jun;59(3):329-335. doi: 10.1016/j.japh.2019.01.012. Epub 2019 Mar 2.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause community-acquired acute kidney injury, especially in high-risk populations. Both the U.S. Food and Drug Administration (FDA) medication guide and over-the-counter labeling vaguely describe kidney risks of NSAIDs and do not provide information for patients to evaluate their risk for kidney problems. The purpose of this study was to use a mobile application to evaluate the impact of patient choice of media delivering NSAID avoidance education on patient knowledge about kidney risks associated with NSAIDs.
Prospective cohort study. The mobile application was used to deliver either a redesigned FDA medication guide or a video focused on NSAID risks (selected by the patient), followed by patient knowledge questions (PKQs) and a kidney risk assessment.
One hundred fifty adult primary care patients in southeast Michigan.
The primary outcome was the score on 5 NSAID PKQs between the media selected. Secondary outcomes included characterization of media choice among different demographic and NSAID kidney risk groups. The relationship between kidney risk assessment and self-reported NSAID avoidance behavior also was evaluated.
The majority of participants (72.7%) chose to review print material. Those that chose print had significantly higher PKQ scores (5 total points) compared with participants who selected the video: mean scores 4.2 ± 0.9 with print and 3.8 ± 1.0 with video (P = 0.034). Older patients (>65 years) had significantly lower PKQ scores compared with other age groups. Forty-four percent of individuals (n = 66) reported current NSAID use, and 65% stated that they would avoid NSAIDs after the selected education material.
Scores for questions related to NSAID kidney risk knowledge were higher among participants who chose print compared with video education material. Education regarding NSAID kidney risks encouraged patients to limit their use. Targeted education may be beneficial in high-risk (e.g., older) patients and should be further studied.
非甾体抗炎药（NSAIDs）可导致社区获得性急性肾损伤，尤其是在高危人群中。美国食品和药物管理局（FDA）的用药指南和非处方标签都含糊地描述了 NSAIDs 的肾脏风险，但并未为患者提供评估肾脏问题风险的信息。本研究旨在使用移动应用程序评估患者选择传递 NSAID 规避教育的媒体对患者了解 NSAIDs 相关肾脏风险的影响。
前瞻性队列研究。该移动应用程序用于提供经重新设计的 FDA 用药指南或侧重于 NSAID 风险的视频（由患者选择），然后是患者知识问题（PKQs）和肾脏风险评估。
密歇根州东南部的 150 名成年初级保健患者。
主要结局是两种所选媒体之间的 5 个 NSAID PKQs 的得分。次要结局包括不同人口统计学和 NSAID 肾脏风险组之间的媒体选择特征。还评估了肾脏风险评估与自我报告的 NSAID 回避行为之间的关系。
大多数参与者（72.7%）选择查看印刷材料。选择印刷材料的参与者的 PKQ 得分（总分 5 分）明显高于选择视频的参与者：印刷材料的平均得分为 4.2±0.9，视频为 3.8±1.0（P=0.034）。与其他年龄组相比，年龄较大的患者（>65 岁）的 PKQ 得分明显较低。44%的个体（n=66）报告目前正在使用 NSAID，并且 65%的个体表示在选择了教育材料后将避免使用 NSAID。
与选择视频教育材料的参与者相比，选择印刷材料的参与者与 NSAID 肾脏风险知识相关的问题得分更高。关于 NSAID 肾脏风险的教育鼓励患者限制其使用。有针对性的教育可能对高危人群（例如老年人）有益，应进一步研究。
