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患者自身用药对住院期间患者自我报告药物知识的影响:一项干预前后研究。

The effect of Patient's Own Medication use on patient's self-reported medication knowledge during hospitalisation: a pre-post intervention study.

机构信息

Department of Pharmacy, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.

Department of Pharmacy, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.

出版信息

BMC Health Serv Res. 2022 Mar 30;22(1):423. doi: 10.1186/s12913-022-07752-6.

Abstract

BACKGROUND

Improving patient's medication knowledge and consequently medication use is essential for optimal treatment outcomes. As patient knowledge about medication is currently suboptimal, interventions to optimise medication knowledge are necessary. Implementation of Patient's Own Medication (POM) in which patients bring their outpatient medication to the hospital, and nurses administer these during admission, may increase medication knowledge. The aim of this study is to explore the impact of POM use on self-reported medication knowledge of hospitalised patients compared to standard care. Patient's sense of medication safety, attitude to the provision of information, and to inpatient medication use were studied in both standard care and during POM use too.

METHOD

In this nationwide intervention study perceived medication knowledge was assessed with a questionnaire pre and post implementing POM use. The questionnaire assessed perceived medication knowledge at admission and discharge, medication safety during hospitalisation, the provision of information during hospitalisation and at discharge, and inpatient medication use during hospitalisation. Patients' answers were categorised into positive and negative/neutral. The proportion of patients with adequate medication knowledge, in the standard care and POM use group at hospital admission and discharge, were calculated and compared with adjustment for potential confounders.

RESULTS

Among the 731 patients (393 received standard care and 338 POM) who completed the questionnaire (80.2%), POM use seemed to be positively associated with self-reported knowledge on how to use medication at discharge (adjusted OR: 3.22 [95% CI 2.01-5.16]). However, for the other two knowledge related statements POM use was not associated. Medication knowledge at admission was the most important variable associated with perceived medication knowledge at discharge. The majority perceived POM use to be safer (52.9% of standard care patients versus 74.0% POM users; P <  0.01), POM users knew better which medicines they still used during hospitalisation (85.8% versus 92.3% resp.; P = 0.01), and most patients preferred POM use regardless of having experienced it (68.2% versus 82.2% resp.; P <  0.01).

CONCLUSION

POM use positively affects patient's medication knowledge about how to use medication and patients' perception of medication safety. With POM use more patients have a positive attitude towards the provision of information. The majority of patients prefer POM use. In conclusion, POM use seems a valuable intervention and requires further investigation.

摘要

背景

提高患者的药物知识,进而改善药物使用情况,对实现最佳治疗效果至关重要。鉴于目前患者对药物的了解并不理想,有必要采取干预措施来优化药物知识。实施患者自带药物(POM)方案,即让患者将门诊用药带到医院,由护士在住院期间为其管理,可能会提高药物知识。本研究旨在探讨与标准护理相比,POM 使用对住院患者自我报告的药物知识的影响。还研究了标准护理和 POM 使用期间患者的药物安全感、对信息提供的态度以及住院期间的药物使用情况。

方法

在这项全国性干预研究中,使用问卷在实施 POM 使用前后评估了感知药物知识。问卷评估了入院时和出院时的感知药物知识、住院期间的药物安全性、住院期间和出院时的信息提供情况以及住院期间的住院药物使用情况。将患者的回答分为积极和消极/中立。计算了标准护理和 POM 使用组患者在入院和出院时具有足够药物知识的比例,并针对潜在混杂因素进行了调整。

结果

在完成问卷的 731 名患者(393 名接受标准护理,338 名接受 POM)中(80.2%),POM 使用似乎与出院时自我报告的用药知识呈正相关(调整后的 OR:3.22 [95% CI 2.01-5.16])。然而,对于其他两个与知识相关的陈述,POM 使用与它们并无关联。入院时的药物知识是与出院时感知药物知识最相关的变量。大多数人认为 POM 使用更安全(52.9%的标准护理患者与 74.0%的 POM 用户;P<0.01),POM 用户更清楚他们在住院期间仍在使用哪些药物(85.8%与 92.3%;P=0.01),而且大多数患者无论是否经历过 POM 使用都更喜欢 POM 使用(68.2%与 82.2%;P<0.01)。

结论

POM 使用可积极影响患者对如何使用药物的药物知识以及患者对药物安全性的看法。使用 POM 后,更多的患者对信息的提供持积极态度。大多数患者更喜欢使用 POM。总之,POM 使用似乎是一种有价值的干预措施,需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac7a/8969375/47d2824efbd4/12913_2022_7752_Fig1_HTML.jpg

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