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初级保健患者对处方药物的认知:Prover 项目的研究结果。

Knowledge of prescribed drugs among primary care patients: findings from Prover Project.

机构信息

Oswaldo Cruz Foundation (Fiocruz Minas), Av Augusto de Lima, 1715, Anexo, Barro Preto, Belo Horizonte, Minas Gerais, 30190-009, Brazil.

Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK.

出版信息

Int J Clin Pharm. 2021 Oct;43(5):1265-1273. doi: 10.1007/s11096-021-01246-x. Epub 2021 Mar 12.

Abstract

Background Evidence on patient medication knowledge and associated factors within primary care patients is limited, especially in developing countries. Objective To estimate the prevalence and investigate the role of individual and contextual factors on insufficient medication knowledge among primary care patients. Setting Public community pharmacies in a health pole city (234,937 inhab.) in Minas Gerais State, Brazil. Methods Exit-survey conducted with a representative sample of 1221 patients (≥ 18 years) interviewed after dispensing. Data collected for medicines included its name, therapeutic indication, dosage, time of administration, treatment duration, side effects and warnings. Information were compared to the prescription and official guidelines. Descriptive statistics and logistic regression analysis were applied. Main outcome measure Insufficient patient medication knowledge. Results Prevalence of insufficient medication knowledge was 30.1%. Side effects (96.3%) and warnings (71.1%) had the highest percentage of misses. Musculoskeletal system drugs presented the lowest knowledge score (mean = 5.9; SD = 1.9). Significant determinants of insufficient medication knowledge with respective odds ratio (OR) were: level of education (≤ 3 years, OR 1.50; 95% CI 1.06-2.11 and 4-7 years, OR 1.37; 95% CI 1.02-1.84), number of comorbidities (≤ 2, OR 1.36; 95% CI 1.04-1.77), use of prescription drugs in the last 15 days (no, OR 2.22; 95% CI 1.31-3.76) and number of people able to lend money (no person, OR 1.34; 95% CI 1.04-1.74). Conclusion Counselling and monitoring practices should be tailored to patients with less schooling, that are initiating treatment and with low disease burden. Equally important is the need to implement strategies to increase the patient's level of social capital to improve treatment knowledge.

摘要

背景 在初级保健患者中,关于患者药物知识和相关因素的证据有限,尤其是在发展中国家。目的 评估初级保健患者中药物知识不足的流行率,并研究个体和环境因素的作用。地点 巴西米纳斯吉拉斯州一个健康极点城市(234937 名居民)的公共社区药房。方法 在配药后对 1221 名(≥18 岁)代表性患者样本进行出口调查。收集的药物数据包括药物名称、治疗适应症、剂量、给药时间、治疗持续时间、副作用和警告。信息与处方和官方指南进行了比较。应用描述性统计和逻辑回归分析。主要结果 药物知识不足的患者。结果 药物知识不足的患病率为 30.1%。副作用(96.3%)和警告(71.1%)的遗漏率最高。肌肉骨骼系统药物的知识得分最低(平均 5.9;SD 1.9)。与药物知识不足显著相关的决定因素,其相应的比值比(OR)分别为:教育水平(≤3 年,OR 1.50;95%CI 1.06-2.11 和 4-7 年,OR 1.37;95%CI 1.02-1.84),合并症数量(≤2,OR 1.36;95%CI 1.04-1.77),过去 15 天内使用处方药(否,OR 2.22;95%CI 1.31-3.76)和能够借钱的人数(无人,OR 1.34;95%CI 1.04-1.74)。结论 应根据受教育程度较低、开始治疗和疾病负担较低的患者调整咨询和监测实践。同样重要的是,需要实施增加患者社会资本水平的策略,以提高治疗知识。

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