Lam Ziyen, Aikman Kiri Louise, Chan Amy Hai Yan
Department of Pharmacy, Auckland District Health Board, Auckland, New Zealand.
School of Pharmacy, University of Auckland, Auckland, New Zealand.
Eur J Hosp Pharm. 2019 Jul;26(4):193-198. doi: 10.1136/ejhpharm-2017-001399. Epub 2018 Feb 28.
Health literacy is poor in many health service users. Although interventions exist, none have been implemented during an inpatient setting. This pilot study investigated the effect of a brief intervention, delivered by hospital pharmacists during an inpatient admission, on patient self-reported understanding of their health condition and medication-one aspect of health literacy.
Patients admitted to a tertiary hospital in New Zealand on one or more high-risk medication were included. Patients received a brief intervention discussing four steps (PLAN) to help patients: Prepare for their next health visit, Listen and share concerns, Ask questions and Note what to do next. The primary outcome was patient self-reported understanding of their health condition and medication. Secondary outcomes were number and types of pharmacist interventions, patient satisfaction and pharmacist intervention acceptability.
Thirty-eight patients received the intervention. Scores improved for how well patients felt they understood their health conditions (increase from 3.65±1.16 to 4.28±0.74, P=0.027), their medication (3.50±1.11 to 4.44±0.77, P=0.001) and how to take their medication (4.12±0.95 to 4.60±0.76, P=0.051). Additional pharmacy interventions were made for 47% of patients. Mean patient satisfaction scores were high (4.64±0.57); however, pharmacist acceptability was only moderately positive with many finding the intervention only somewhat rewarding.
This pilot study shows that a pharmacist-delivered intervention can have an effect on an aspect of health literacy in an inpatient setting. It suggests the potential for further inpatient interventions, which target health literacy issues.
许多医疗服务使用者的健康素养较差。尽管存在相关干预措施,但尚未在住院环境中实施。这项试点研究调查了医院药剂师在患者住院期间进行的简短干预对患者自我报告的对自身健康状况和用药情况的理解(健康素养的一个方面)的影响。
纳入在新西兰一家三级医院因使用一种或多种高风险药物而入院的患者。患者接受了一次简短干预,讨论了四个步骤(PLAN)以帮助患者:为下次健康就诊做准备、倾听并分享担忧、提问以及记录下一步该做什么。主要结局是患者自我报告的对自身健康状况和用药情况的理解。次要结局包括药剂师干预的数量和类型、患者满意度以及药剂师干预的可接受性。
38名患者接受了干预。患者对自身健康状况的理解程度(从3.65±1.16提高到4.28±0.74,P = 0.027)、用药情况(从3.50±1.11提高到4.44±0.77,P = 0.001)以及如何用药(从4.12±0.95提高到4.60±0.76,P = 0.051)的得分均有所提高。47%的患者接受了额外的药学干预。患者平均满意度得分较高(4.64±0.57);然而,药剂师的可接受性仅为中等积极,许多人认为该干预只是有一定收获。
这项试点研究表明,药剂师实施的干预可对住院患者的健康素养方面产生影响。这表明针对健康素养问题的进一步住院干预具有潜力。