Sydney School of Public Health, ASK-GP Centre of Research Excellence, The University of Sydney, NSW, Australia.
Wiser Health Care, The University of Sydney, Sydney, NSW, Australia.
Br J Clin Pharmacol. 2019 Jul;85(7):1396-1406. doi: 10.1111/bcp.13912. Epub 2019 May 7.
To identify and evaluate content and readability of freely available online deprescribing patient education materials (PEMs).
Systematic review of PEMs using MEDLINE, Embase, CINAHL, PsycINFO and The Cochrane Library of Systematic Reviews from inception to 25 September 2017 to identify PEMs. Additionally, deprescribing researchers and health professionals were surveyed to identify additional materials. Known repositories of materials were searched followed by a systematic Google search (22-28 January 2018). Materials were evaluated using an approach informed by the Patient Education Material Assessment Tool and the International Patient Decision Aids Standards Inventory. Readability of text-based materials was assessed using the US-based Gunning-Fog Index and Flesch-Kincaid Grade level.
Forty-eight PEMs were identified. PEMs addressing deprescribing of medications for symptom control (81%) were most common. Preventative medications were rarely addressed and material (39%) focused on older people. Only 37% of PEMs provided information about both potential benefits (e.g. reducing risk of side effects) and harms (e.g. withdrawal symptoms, increased risk of disease) of deprescribing, while 40% focussed on benefits only. Readability indices indicated an average minimum reading level of Grade 12. Option Grids and Decision Aids (mean reading level below Grade 10) were most suitable for people with average literacy levels.
Over 1/3 of deprescribing PEMs present potential benefits and harms of deprescribing indicating most of the freely available materials are not balanced. Most PEMs are pitched above average reading levels making them inaccessible for low health literacy populations.
识别和评估可免费获得的在线药物减量患者教育材料（PEM）的内容和可读性。
系统检索 MEDLINE、Embase、CINAHL、PsycINFO 和 The Cochrane Library of Systematic Reviews 从建库至 2017 年 9 月 25 日的 PEM 文献，以确定 PEM。此外，还调查了药物减量研究人员和卫生专业人员以确定其他材料。搜索了已知的材料库，然后进行了系统的 Google 搜索（2018 年 1 月 22 日至 28 日）。使用患者教育材料评估工具和国际患者决策辅助工具标准清单来评估材料。使用基于美国的 Gunning-Fog 指数和 Flesch-Kincaid 等级来评估基于文本的材料的可读性。
共确定了 48 份 PEM。针对药物减量以控制症状的 PEM 最常见（81%）。预防性药物很少涉及，材料（39%）侧重于老年人。只有 37%的 PEM 提供了关于药物减量的潜在益处（例如降低副作用风险）和危害（例如停药症状、疾病风险增加）的信息，而 40%的 PEM 仅关注益处。可读性指数表明平均最低阅读水平为 12 年级。选项网格和决策辅助工具（阅读水平低于 10 年级）最适合平均识字水平的人群。
超过 1/3 的药物减量 PEM 提出了药物减量的潜在益处和危害，这表明大多数免费提供的材料并不平衡。大多数 PEM 的阅读水平高于平均水平，使得阅读能力较低的人群难以获取。
