School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia.
AstraZeneca Limited, Petaling Jaya, Malaysia.
J Med Internet Res. 2024 Sep 18;26:e56591. doi: 10.2196/56591.
While perceptions of electronic labeling (e-labeling) in developed countries have been generally positive, existing data primarily come from studies involving hospital pharmacists, community pharmacy customers who may not be frequent medication users, and individuals receiving COVID-19 vaccines.
This study aims to assess e-labeling acceptance, perceptions of its benefits, challenges with its implementation, and preferences among hospital ambulatory care patients in Malaysia. Additionally, the study investigates the factors influencing patients' acceptance of e-labeling.
A cross-sectional study using a 28-item questionnaire was conducted at the outpatient pharmacy department of a quaternary hospital in Kuala Lumpur, Malaysia, from May to June 2023. The questionnaire was developed based on a review of published literature related to e-labeling and was guided by the Unified Theory of Acceptance and Use of Technology, second version (UTAUT2). Patients aged 18 years and above were recruited using a stratified sampling method to ensure representative age-related medication usage. A mobile tablet was provided to patients for self-completion of the e-survey in their preferred language (English, Malay, or Mandarin). Categorical data on e-labeling acceptance, perceptions, and preferences were analyzed using descriptive statistics. Qualitative content analysis was performed to characterize participants' responses to open-ended questions. Univariate and multivariate binomial logistic regression analyses were conducted to identify predictors of e-labeling acceptance.
Out of 462 patients approached, 387 (83.8%) participated in the survey, with 283 (73.1%) accepting e-labeling. Most participants perceived the electronic version of the package insert as beneficial, particularly for understanding their medication better through the choice of language (352/387, 91.0%). However, around half of the participants (197/387, 50.9%) expressed concerns about the potential risks of obtaining illegal medication information via e-labeling. Most participants (302/387, 78.0%) preferred to access electronic leaflets through government websites. However, 221/387 (57.1%) still wanted the option to request printed leaflets. Significant predictors of e-labeling acceptance included perceived benefits such as better understanding of medication (adjusted odds ratio [AOR] 8.02, 95% CI 2.80-22.97, P<.001), environmental protection (AOR 7.24, 95% CI 3.00-17.51, P<.001), and flexibility in information retrieval (AOR 2.66, 95% CI 1.11-6.35, P=.03). Conversely, being of Chinese ethnicity compared with Malay (AOR 0.28, 95% CI 0.13-0.60, P=.005) and perceived lack of self-efficacy in browsing electronic leaflets (AOR 0.25, 95% CI 0.11-0.56, P<.001) were associated with lower acceptance.
The acceptance rate for e-labeling among hospital ambulatory care patients was moderately high and was significantly influenced by ethnicity as well as patients' perceived benefits and challenges related to its implementation. Future strategies to enhance e-labeling uptake should address patient concerns regarding the challenges of using the digital platform and emphasize the benefits of e-labeling.
在发达国家，电子标签（e-labeling）的认知普遍较为积极，但现有数据主要来自涉及医院药剂师、可能不是经常使用药物的社区药剂师顾客以及接受 COVID-19 疫苗的个体的研究。
本研究旨在评估马来西亚医院门诊患者对电子标签的接受程度、对其益处的认知、实施过程中的挑战以及偏好。此外，研究还调查了影响患者接受电子标签的因素。
2023 年 5 月至 6 月，在马来西亚吉隆坡的一家四级医院的门诊药房部门，使用包含 28 个项目的问卷进行了一项横断面研究。问卷基于对与电子标签相关的已发表文献的回顾而制定，并以接受和使用技术的统一理论，第二版（UTAUT2）为指导。使用分层抽样方法招募年龄在 18 岁及以上的患者，以确保具有代表性的与年龄相关的药物使用。向患者提供移动平板电脑，以便他们以自己喜欢的语言（英语、马来语或普通话）自行完成电子调查。使用描述性统计分析电子标签接受度、认知和偏好的分类数据。对开放式问题的回答进行定性内容分析。使用单变量和多变量二项逻辑回归分析来确定电子标签接受度的预测因素。
在 462 名被接触的患者中，有 387 名（83.8%）参与了调查，其中 283 名（73.1%）接受了电子标签。大多数参与者认为药品说明书的电子版很有帮助，特别是通过选择语言来更好地理解他们的药物（352/387，91.0%）。然而，约一半的参与者（197/387，50.9%）对通过电子标签获取非法药物信息的潜在风险表示担忧。大多数参与者（302/387，78.0%）更喜欢通过政府网站访问电子传单。然而，仍有 221/387（57.1%）名参与者希望保留索取印刷传单的选项。电子标签接受度的显著预测因素包括更好地理解药物（调整后的优势比[OR]8.02，95%置信区间[CI]2.80-22.97，P<.001）、环境保护（OR 7.24，95%CI 3.00-17.51，P<.001）和信息检索的灵活性（OR 2.66，95%CI 1.11-6.35，P=.03）等感知益处。相比之下，与马来族（OR 0.28，95%CI 0.13-0.60，P=.005）相比，华族（OR 0.28，95%CI 0.13-0.60，P=.005）以及感知在浏览电子传单方面缺乏自我效能（OR 0.25，95%CI 0.11-0.56，P<.001）与较低的接受率相关。
医院门诊患者对电子标签的接受率适中，且受到种族以及患者对其实施的益处和挑战的感知的显著影响。未来增强电子标签使用率的策略应解决患者对使用数字平台的挑战的担忧，并强调电子标签的益处。
