School of Medicine and Health Sciences, The George Washington University, Washington, DC.
College of Medicine, SUNY Upstate Medical University, Syracuse.
J Glaucoma. 2020 Jul;29(7):529-535. doi: 10.1097/IJG.0000000000001518.
PRéCIS:: To assess the after-visit summary (AVS) as a tool for glaucoma medication recall. Medication recall was associated with level of education and complexity of medication regimen. Receiving an AVS was not associated with better medication recall.
The purpose of this study was to determine whether patients given the AVS have better or worse glaucoma medication recall.
Observational clinical study. Adults on ≥1 glaucoma medications examined between June 30, 2017 and August 2, 2017.
in-person questionnaire and retrospective chart review. Self-reported glaucoma medications compared with prescribed glaucoma medication regimen verified by electronic medical record. Medication recall assessed using 3-point scoring: 1 point each for; (1) name or color of bottle or cap; (2) treatment eye(s); and (3) dosing regimen.
2-sample Welch t test, 2-proportion z-test, analysis of variance, univariate, and multivariate regression.
A total of 118 patients enrolled: age 69.7±12.9 years (mean±SD), 55.9% of patients had received an AVS at the previous visit. Of these, 33.3% reported receiving an AVS, 51.2% reported not receiving one (15.1% did not recall or respond). Patients who had received AVSs had lower medication recall scores than those who did not (2.4±1.0 vs. 2.7±0.6, P=0.04). Receipt of an AVS was associated with having Nisha Chadha as their provider (P=0.01), fewer days since prior visit (P=0.0001), and medication regimen change at prior visit (P<0.0001). Multivariate analysis revealed completion of associate's degree or higher and fewer prescribed medications to be independent predictors of higher recall score (P=0.0002 and 0.002).
AVSs were conceived to enhance patient care. This study indicates this goal is not achieved consistently. Less education and more complex medication regimens were identified as barriers to medication recall. Additional investigations should explore if modifying this document and enhanced explanation of its use will impact medication recall and health outcomes.
摘要：评估就诊后总结（AVS）作为一种青光眼药物记忆工具。药物记忆与教育水平和药物方案的复杂性相关。接受 AVS 与更好的药物记忆无关。
本研究旨在确定给予 AVS 的患者是否具有更好或更差的青光眼药物记忆。
观察性临床研究。2017 年 6 月 30 日至 2017 年 8 月 2 日期间检查的至少使用 1 种青光眼药物的成年人。
面对面问卷调查和病历回顾。通过电子病历验证自我报告的青光眼药物与处方的青光眼药物方案进行比较。使用 3 分制评估药物记忆：每瓶或帽的名称或颜色记 1 分；（2）治疗眼（s）；和（3）剂量方案。
两样本 Welch t 检验、两比例 z 检验、方差分析、单变量和多变量回归。
共纳入 118 例患者：年龄 69.7±12.9 岁（均值±标准差），55.9%的患者在上次就诊时收到了 AVS。其中，33.3%的患者报告收到了 AVS，51.2%的患者报告未收到（15.1%未回忆或未回答）。接受过 AVS 的患者的药物记忆评分低于未接受过 AVS 的患者（2.4±1.0 与 2.7±0.6，P=0.04）。接受 AVS 与 Nisha Chadha 作为其提供者有关（P=0.01）、就诊间隔时间较短（P=0.0001）和上次就诊时药物方案改变有关（P<0.0001）。多变量分析显示，完成副学士学位或更高学历以及服用的药物较少是记忆评分较高的独立预测因素（P=0.0002 和 0.002）。
AVS 的设计初衷是增强患者护理。本研究表明，这一目标并未始终实现。受教育程度较低和药物方案更复杂被确定为药物记忆障碍的障碍。应进一步研究是否修改该文件并加强对其使用的解释是否会影响药物记忆和健康结果。
