O'Donovan Bernadine, Kirke Ciara, Pate Muriel, McHugh Sheena, Bennett Kathleen, Cahir Caitríona
Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Medication Safety, Quality Improvement Division, Health Service Executive (HSE), Dublin, Ireland.
Health Expect. 2025 Apr;28(2):e70256. doi: 10.1111/hex.70256.
Shared decision-making in the context of medication management has been shown to be contingent on information-seeking behaviours such as patient knowledge, self-efficacy and engagement.
The aim of this study was to: (i) compare differences in perceptions of patients' knowledge, capabilities and engagement across healthcare professionals (HCPs) and patients and family caregivers and (ii) investigate associations between these factors and patients' medication beliefs using a cross-sectional survey study of patients, family caregivers and community and hospital HCPs in Ireland.
Two cross-sectional surveys measuring key factors in medication management were distributed to patients and family caregivers taking three or more medicines and HCPs involved in medicines management. χ tests were used to investigate differences between HCPs and patients and family caregivers. Multivariable linear regression with adjustment for the socio-demographic covariates was used to examine key factors in medication management and beliefs about medicine (BMQ-General) in patients and family caregivers.
Overall, 636 responses were received; patients and family caregivers (N = 134, 21%), community (N = 313, 49%) and hospital HCPs (N = 189, 30%). A higher proportion of patients and family caregivers self-reported as 'knowledgeable' about medications (N = 76; 56.7%) than community (N = 75, 24%) and hospital HCPs (N = 44, 23.3%) (p < 0.01). The majority of patients and family caregivers were 'fairly/very confident' they could maintain an accurate medication list without assistance (N = 78; 58.2%), compared to the majority of the community (N = 213, 68.1%) and hospital HCPs (N = 114, 60.3%) who were 'not at all/somewhat confident' (p < 0.01.) These patients and family caregivers also had significantly lower overall beliefs in medication harm (β = -1.23, 95% CI: -2.34, -0.13). Patient and family caregivers who asked HCPs about their medication frequently (> 7 times per year) had higher overall beliefs in medication overuse (β = 1.88, 95% CI: 0.06, 3.69) and medication harm (β = 2.65, 95% CI: 1.10, 4.20), compared to those who never asked.
There was divergence between HCPs and patients and family caregivers in their assessments of patients' medication knowledge and capabilities. Engagement between HCPs and patients around medication should be purposeful rather than frequent, to alleviate fears about overuse and harm.
The patient and family caregiver survey was developed in partnership with members of the Patient and Public Involvement (PPI) group. Feedback was provided by the group to increase accessibility of survey and maximise distribution. In addition, the survey was piloted among members of the public involved in medication management.
在药物管理背景下的共同决策已被证明取决于诸如患者知识、自我效能感和参与度等信息寻求行为。
本研究的目的是：（i）比较医疗保健专业人员（HCPs）、患者以及患者家属和护理人员对患者知识、能力和参与度认知的差异；（ii）通过对爱尔兰的患者、患者家属和护理人员以及社区和医院的医疗保健专业人员进行横断面调查研究，调查这些因素与患者用药信念之间的关联。
向服用三种或更多药物的患者和患者家属及护理人员以及参与药物管理的医疗保健专业人员发放了两份测量药物管理关键因素的横断面调查问卷。χ检验用于调查医疗保健专业人员与患者以及患者家属和护理人员之间的差异。使用对社会人口统计学协变量进行调整的多变量线性回归来检查患者和患者家属及护理人员在药物管理和药物信念（BMQ-一般）方面的关键因素。
总共收到636份回复；患者和患者家属及护理人员（N = 134，21%）、社区（N = 313，49%）和医院医疗保健专业人员（N = 189，30%）。自我报告对药物“了解”的患者和患者家属及护理人员的比例（N = 76；56.7%）高于社区（N = 75，24%）和医院医疗保健专业人员（N = 44，23.3%）（p < 0.01）。大多数患者和患者家属及护理人员“相当/非常有信心”在没有帮助的情况下能够维持准确的用药清单（N = 78；58.2%），相比之下，大多数社区（N = 213，68.1%）和医院医疗保健专业人员（N = 114，60.3%）“完全没有/有点信心”（p < 0.01）。这些患者和患者家属及护理人员对药物危害的总体信念也显著较低（β = -1.23，95%置信区间：-2.34，-0.13）。与从不询问的患者和患者家属及护理人员相比，每年向医疗保健专业人员询问药物情况超过7次的患者和患者家属及护理人员对药物过度使用（β = 1.88，95%置信区间：0.06，3.69）和药物危害（β = 2.65，95%置信区间：1.10，4.20）的总体信念更高。
医疗保健专业人员与患者以及患者家属和护理人员在对患者用药知识和能力的评估上存在差异。医疗保健专业人员与患者围绕药物进行的互动应该是有目的的，而不是频繁的，以减轻对过度使用和危害的担忧。
患者和患者家属及护理人员调查问卷是与患者和公众参与（PPI）小组的成员合作制定的。该小组提供了反馈，以提高调查问卷的可及性并最大限度地扩大分发范围。此外，该调查问卷在参与药物管理的公众成员中进行了预试验。
