Mourad Nisreen, Younes Samar, Mourad Lidia, Fahs Iqbal, Mayta Shatha, Baalbaki Racha, El Basset Wassim, Dabbous Mariam, El Akel Marwan, Safwan Jihan, Saade Faraj, Rahal Mohamad, Sakr Fouad
School of Pharmacy, Lebanese International University, Bekaa, Lebanon.
INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.
BMC Public Health. 2023 Oct 5;23(1):1926. doi: 10.1186/s12889-023-16856-5.
Medication errors can often occur due to the patient's inability to comprehend written or verbal medication orders. This study aimed to develop pictograms of selected medication orders and to validate the comprehension of prescription orders index and compare the comprehension scores with and without pictograms. In addition to determine the predictors that could be associated with a better or worse comprehension of prescription orders with pictograms versus that of their written counterparts.
A cross-sectional study was conducted using a snowball sampling technique. Six pictograms were developed to depict specific medication orders. The comprehension of prescription orders index was constructed and validated. The study then compared the comprehension scores of prescription orders with and without pictograms, and identified the predicting factors score difference.
A total of 1848 participants were included in the study. The structure of the comprehension of prescription orders index was validated over a solution of four factors, with an adequate Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy of 0.711 and a significant Bartlett's test of sphericity (P < 0.001). The construct validity of the index was further confirmed by highly significant correlations between each item and the full index (P < 0.001). The study also found a significant association between the difference in comprehension scores for prescription orders with and without pictograms and several factors, including age, level of education, area of residence, number of children, and smoking status with the difference of comprehension scores (P < 0.001).
Pictogram-based instructions of medication orders were better understood by the Lebanese population than written instructions, making the incorporation of pictograms in pharmacy practice paramount to optimize medication use by the patient and thus yielding better health outcomes.
由于患者无法理解书面或口头用药医嘱，用药错误经常发生。本研究旨在开发选定用药医嘱的象形图，验证处方医嘱理解指数，并比较有无象形图时的理解得分。此外，确定与有象形图的处方医嘱相比书面处方医嘱理解更好或更差可能相关的预测因素。
采用雪球抽样技术进行横断面研究。开发了六个象形图来描绘特定的用药医嘱。构建并验证了处方医嘱理解指数。然后，该研究比较了有无象形图时处方医嘱的理解得分，并确定了预测因素得分差异。
共有1848名参与者纳入研究。处方医嘱理解指数的结构在四个因素的解决方案上得到验证，Kaiser-Meyer-Olkin（KMO）抽样适当性度量为0.711，Bartlett球形检验显著（P < 0.001）。各项目与完整指数之间的高度显著相关性进一步证实了该指数的结构效度（P < 0.001）。该研究还发现，有无象形图的处方医嘱理解得分差异与几个因素之间存在显著关联，包括年龄、教育程度、居住地区、子女数量和吸烟状况与理解得分差异（P < 0.001）。
黎巴嫩人群对比书面说明，更能理解基于象形图的用药医嘱说明，因此在药房实践中纳入象形图对于优化患者用药从而产生更好的健康结果至关重要。
