Kuipers Esther, Wensing Michel, De Smet Peter Agm, Teichert Martina
Radboud University Medical Centre, Radboud Institute for Health Sciences, Department of IQ Healthcare, Nijmegen 6500 HB, The Netherlands.
BENU Apotheek Zeist West, Zeist, The Netherlands.
Patient Prefer Adherence. 2020 Jan 29;14:203-212. doi: 10.2147/PPA.S234094. eCollection 2020.
Treatment of obstructive lung disease with inhalation therapy needs changes in patient behavior. Shortly after the start with inhaled corticosteroids (ICS) maintenance therapy, patients might be in need of additional pharmaceutical care, tailored to their individual needs. This study aimed to provide insight into patient behavior, goals and perceptions regarding their medical treatment at start with ICS therapy, by telephone interviews with ICS starters. Besides, this study investigated pharmacists' and patients' experiences with these interviews and opinions on the utility of this type of consultation for daily practice.
Semi-structured telephone interviews were conducted by pharmacists with adult patients 2-3 weeks after starting ICS. The Theoretical Domain Framework (TDF) was used for data analysis and coding. Afterward, the patients and pharmacists were questioned about their experiences with the interview.
Five pharmacists conducted interviews with 23 ICS starters. Except the domains "environmental context and resources", "optimism", and "reinforcement", the remaining 11 domains in the TDF were addressed in the interviews. The majority of patients defined personal goals, which mainly addressed disease or symptom control (clinical goals). Some patients showed a lack of knowledge regarding the clinical indication or therapy duration. Views on beneficial medication effects differed between patients. Some patients specifically mentioned concerns or anxiety about side effects. The interviewees described different perceptions on the necessity of a personalized routine for regular medication use. Patients and pharmacists both felt positive about an added value of these interviews for daily practice.
Patient interviews shortly after start with ICS therapy revealed various perceptions and beliefs that might influence medication use and achievement of individual treatment goals. The patients appreciated the opportunity to ask questions and share their perspectives and needs with their pharmacist, and the pharmacists experienced that the interviews had added value.
吸入疗法治疗阻塞性肺病需要患者行为发生改变。在开始吸入性糖皮质激素（ICS）维持治疗后不久，患者可能需要根据其个人需求提供的额外药学服务。本研究旨在通过对开始使用ICS的患者进行电话访谈，深入了解患者在开始ICS治疗时的行为、目标以及对其医疗治疗的看法。此外，本研究调查了药剂师和患者对这些访谈的体验以及对这类咨询在日常实践中的效用的看法。
药剂师在患者开始使用ICS 2至3周后对成年患者进行半结构化电话访谈。使用理论领域框架（TDF）进行数据分析和编码。之后，询问患者和药剂师对访谈的体验。
五名药剂师对23名开始使用ICS的患者进行了访谈。除了“环境背景与资源”、“乐观主义”和“强化”领域外，TDF中的其余11个领域在访谈中均有涉及。大多数患者确定了个人目标，主要涉及疾病或症状控制（临床目标）。一些患者对临床适应症或治疗持续时间缺乏了解。患者对药物有益效果的看法各不相同。一些患者特别提到了对副作用的担忧或焦虑。受访者对定期用药个性化常规的必要性有不同看法。患者和药剂师都对这些访谈对日常实践的附加价值持积极态度。
在开始ICS治疗后不久对患者进行访谈，揭示了各种可能影响药物使用和个人治疗目标实现的看法和信念。患者赞赏有机会向药剂师提问并分享他们的观点和需求，药剂师也体验到这些访谈具有附加价值。
