Jang Soo Min, Parker Wendy M, Pai Amy Barton, Jiang Ruixin, Cardone Katie E
J Am Pharm Assoc (2003). 2020 Nov-Dec;60(6):957-962.e1. doi: 10.1016/j.japh.2020.07.010. Epub 2020 Aug 16.
Patients on hemodialysis have complicated medication regimens requiring the ability to accurately interpret medication information. Literacy and numeracy skills have been shown to differ by the types of materials provided to patients. The aims of this study were to determine prescription and over-the-counter medication label understanding and to assess the prevalence of low health literacy regarding medication labeling among in-center hemodialysis patients.
DESIGN, SETTING AND PARTICIPANTS: The Medication Literacy and Numeracy in Dialysis (MedLitD) tool is an assessment of a person's ability to read and understand medication labels. A comparison with the Rapid Estimate of Adult Literacy in Medicine Short Form (REALM-SF), an established literacy tool, was conducted to determine if there were differences in the literacy results from the 2 tools that could be leveraged to target education initiatives for this specialized population.
A total of 110 patients receiving hemodialysis from 3 dialysis facilities in the Capital Region of upstate New York were enrolled in the study. Most patients (77%) achieved a maximum REALM-SF score, indicating a high level of literacy proficiency; however, their MedLitD scores varied. Patients who were 65 years and older had lower scores on the MedLitD tool compared with younger patients. Gender, education, and the number of medications did not influence the MedLitD scores. Only 16% of all participants correctly answered the question asking for an indication of the phosphate binder (PB), although the most patients were currently taking PBs.
A continuum of medication literacy levels exists among patients on hemodialysis. Appropriate evaluation of medication literacy should be done to better inform individualized education and counseling.
接受血液透析的患者用药方案复杂，需要具备准确解读用药信息的能力。读写能力和计算能力会因提供给患者的材料类型而有所不同。本研究的目的是确定患者对处方药和非处方药标签的理解情况，并评估中心血液透析患者中用药标签健康素养较低的患病率。
设计、地点和参与者：透析用药素养与计算能力（MedLitD）工具用于评估一个人阅读和理解用药标签的能力。将其与已有的成人医学快速识字评估简表（REALM-SF）进行比较，以确定这两种工具在识字结果上是否存在差异，从而为针对这一特殊人群的教育举措提供依据。
来自纽约州北部首府地区3个透析机构的110名接受血液透析的患者参与了本研究。大多数患者（77%）在REALM-SF中获得了最高分，表明识字水平较高；然而，他们的MedLitD分数各不相同。65岁及以上的患者在MedLitD工具上的得分低于年轻患者。性别、教育程度和用药数量并未影响MedLitD分数。尽管大多数患者目前正在服用磷结合剂（PB），但所有参与者中只有16%正确回答了关于PB适应证的问题。
血液透析患者中存在用药素养水平的连续体。应进行适当的用药素养评估，以便更好地为个性化教育和咨询提供信息。
