Departments of Clinical Pharmacology and Aged Care, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Northern Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia.
BMJ Open. 2019 Dec 11;9(12):e033303. doi: 10.1136/bmjopen-2019-033303.
To develop information leaflets for older inpatients and/or their carers to support deprescribing of antipsychotics, benzodiazepines/Z-drugs and proton pump inhibitors (PPIs).
An iterative mixed-methods approach involving face-to-face user testing and semi-structured interviews was performed over three rounds with consumers and hospital health professionals.
Sydney, New South Wales, Australia.
Thirty-seven consumers (or their carers) aged 65 years or older admitted to hospital in the previous 5 years and taking at least one regular medicine (not the medicine tested) completed user testing. Health professionals included a convenience sample of seven pharmacists and five doctors.
The antipsychotic leaflet was tested in round 1 (consumers, n=10) and revised and retested in round 2 (consumers, n=9; health professionals, n=5). Findings from rounds 1 and 2 informed the design of the benzodiazepine/Z-drug and PPI leaflets tested in round 3 (benzodiazepine/Z-drug consumers, n=9; health professionals, n=7; PPI consumers, n=9). Findings from round 3 informed the final design of all leaflets. Consumer user testing involved 12-13 questions to evaluate consumers' ability to locate and understand information in the leaflet. Usability by health professionals was assessed using the System Usability Scale (SUS).
At least 80% of consumers correctly found and understood the deprescribing information in the leaflets (9 of 12 information points in round 1 (antipsychotic); 10 of 12 in round 2; 12 of 13 (benzodiazepine/Z-drug) and 11 of 12 (PPI) in round 3). Consumers perceived the leaflets to be informative, well-designed and useful aids for ongoing medication management. The SUS scores obtained from health professionals were 91.0±3.8 for the antipsychotic leaflet and 86.4±6.6 for the benzodiazepine/Z-drug leaflet, indicating excellent usability.
Understandable and easy-to-use consumer information leaflets were developed and tested by consumers and health professionals. The feasibility and utility of these leaflets to support deprescribing at transitions of care should be explored in clinical practice.
为老年住院患者及其护理人员编制信息传单，以支持减少抗精神病药、苯二氮䓬类药物/ Z 类药物和质子泵抑制剂 (PPIs) 的使用。
采用面对面的用户测试和半结构化访谈的迭代混合方法，在过去 3 轮中与消费者和医院卫生专业人员进行了 3 轮研究。
澳大利亚新南威尔士州悉尼。
37 名年龄在 65 岁或以上、在过去 5 年内住院且至少服用一种常规药物（非测试药物）的消费者（或其护理人员）完成了用户测试。卫生专业人员包括便利抽样的 7 名药剂师和 5 名医生。
在第 1 轮（消费者，n=10）中测试了抗精神病药传单，并在第 2 轮（消费者，n=9；卫生专业人员，n=5）中进行了修订和重新测试。第 1 轮和第 2 轮的结果为第 3 轮（苯二氮䓬类药物/ Z 类药物消费者，n=9；卫生专业人员，n=7；PPI 消费者，n=9）中测试的苯二氮䓬类药物/ Z 类药物和 PPI 传单的设计提供了信息。第 3 轮的结果为所有传单的最终设计提供了信息。消费者用户测试涉及 12-13 个问题，用于评估消费者在传单中查找和理解信息的能力。卫生专业人员的可用性使用系统可用性量表（SUS）进行评估。
至少 80%的消费者正确找到了并理解了传单中的减药信息（第 1 轮（抗精神病药）中的 12 个信息点中的 9 个；第 2 轮中的 10 个；第 3 轮中的 12 个（苯二氮䓬类药物/ Z 类药物）和 11 个（PPI））。消费者认为传单内容丰富、设计精良，是他们持续进行药物管理的有用辅助工具。卫生专业人员获得的 SUS 评分分别为抗精神病药传单 91.0±3.8 和苯二氮䓬类药物/ Z 类药物传单 86.4±6.6，表明可用性非常好。
通过消费者和卫生专业人员编制和测试了易懂且易于使用的消费者信息传单。应在临床实践中探索这些传单在医疗过渡期支持减药的可行性和实用性。
