Department of Clinical Pharmacology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
BMC Health Serv Res. 2024 Oct 8;24(1):1195. doi: 10.1186/s12913-024-11685-7.
Inadequate medication knowledge may contribute to inappropriate medication use and treatment harms. We aimed to map and synthesise the existing evidence on patients' knowledge of the indications for their medications.
We searched MEDLINE, Embase, CINAHL, PsychInfo and the Cochrane Library for studies that assessed patients' knowledge of the indications for their medications from inception to June 16, 2022. A pair of reviewers independently screened and extracted data on study characteristics, aims, and methods used to assess and report patients' knowledge of the indications for their medications.
We included 99 studies conducted in 33 countries, published between 1979 and 2021, with 42,377 participants in total (median 126 participants [Interquartile range: 63-338]). Studies were observational (n = 77), experimental (n = 18), or qualitative interviews (n = 4). The exact question used to assess knowledge of the indications was reported in 27 studies and was phrased in 25 different ways. Knowledge of the indications was reported as a proportion of either 1) all participants (n = 65) or 2) the total number of medications used by all patients (n = 13). Sixteen studies used both reporting methods, while five only reported a proportion without specifying the denominator. Fourteen studies in various populations reported the number of participants with correct knowledge of all their medications, ranging from 19% (long-term psychiatric in-patients) to 87% (general practice patients).
We did not identify any established scientific standard for assessing patients' knowledge of the indications for their medications. The wide range of study methodologies and reporting styles observed call for a methodological consensus in this research field. Estimates of correct knowledge varied widely between studies, but whether this was due to differences in study populations or study methodology could not be determined. Furthermore, we did not identify any study investigating whether participants' knowledge of the indications for their medications was associated with the quality, e.g. appropriateness, of their treatment.
药物知识不足可能导致药物使用不当和治疗伤害。我们旨在绘制和综合现有关于患者对其用药适应症的知识的证据。
我们检索了 MEDLINE、Embase、CINAHL、PsychInfo 和 Cochrane Library，以评估从开始到 2022 年 6 月 16 日患者对其用药适应症的知识的研究。一对审查员独立筛选并提取了关于研究特征、目的以及用于评估和报告患者对其用药适应症的知识的方法的数据。
我们纳入了 33 个国家开展的 99 项研究，共纳入 42377 名参与者（中位数 126 名[四分位距：63-338]）。研究类型包括观察性研究（n=77）、实验性研究（n=18）或定性访谈（n=4）。27 项研究报告了评估知识的具体问题，以 25 种不同的方式表述。适应症知识的报告方式为 1）所有参与者（n=65）或 2）所有患者使用的药物总数（n=13）的比例。16 项研究使用了这两种报告方法，而 5 项研究仅报告了比例，未指定分母。各种人群的 14 项研究报告了正确了解其所有药物的参与者数量，范围从 19%（长期精神科住院患者）到 87%（普通科患者）。
我们没有发现评估患者对其用药适应症的知识的既定科学标准。观察到的研究方法和报告方式的广泛差异呼吁在该研究领域达成方法共识。研究之间正确知识的估计差异很大，但这是由于研究人群的差异还是研究方法的差异尚无法确定。此外，我们没有发现任何研究调查参与者对其用药适应症的知识是否与治疗质量（例如适当性）相关。
