Weinberger M, Nagle B, Hanlon J T, Samsa G P, Schmader K, Landsman P B, Uttech K M, Cowper P A, Cohen H J, Feussner J R
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, NC.
J Am Geriatr Soc. 1994 Dec;42(12):1295-9. doi: 10.1111/j.1532-5415.1994.tb06515.x.
While health-related quality of life (HRQOL) is increasingly being used as an outcome in clinical trials, it is unknown whether HRQOL assessments are influenced by the method of administration. Within the context of a randomized, controlled trial evaluating a pharmacist intervention for elderly outpatients prescribed at least five medications, we compared telephone and face-to-face administration of the SF-36, a widely used HRQOL measure.
Survey.
General Medicine Clinic, Veterans Affairs Medical Center.
At entry, participants in the randomized trial received continuous care from a general medicine clinic physician, were > or = 65 years of age, and were prescribed > or = 5 regularly scheduled medications. Patients were excluded if they were cognitively impaired and had no caregiver available to participate in the study as a proxy or if they resided in a nursing home.
Subjects completed the SF-36 by telephone at closeout and face-to-face at clinic visits within 1 month (mean = 16.7 days).
Telephone administration required significantly less time than face-to-face interviews (10.2 vs 14.0 minutes, P < 0.001). Although systematic differences between modes of administration were generally small, there were substantial nonsystematic discrepancies for all eight SF-36 scales (mean absolute difference scores ranged from 10.8 to 30.1). Discrepancies were greatest for emotional role functioning, physical role functioning, social functioning, and bodily pain; these four scales also demonstrated low to moderate correlations (.33 to .58).
The two modes of administration may not produce interchangeable results. Researchers should be cautious when mixing modes of administration to elderly patients.
虽然与健康相关的生活质量(HRQOL)在临床试验中越来越多地被用作一项指标,但尚不清楚HRQOL评估是否受给药方式的影响。在一项评估药剂师对至少服用五种药物的老年门诊患者进行干预的随机对照试验背景下,我们比较了广泛使用的HRQOL测量工具SF-36的电话给药和面对面给药方式。
调查。
退伍军人事务医疗中心综合内科诊所。
入组时,随机试验的参与者接受综合内科诊所医生的持续护理,年龄≥65岁,且定期服用≥5种药物。如果患者存在认知障碍且没有护理人员可作为代理人参与研究,或者居住在养老院,则被排除。
受试者在研究结束时通过电话完成SF-36,在1个月内(平均=16.7天)的门诊就诊时面对面完成。
电话给药所需时间明显少于面对面访谈(10.2分钟对14.0分钟,P<0.001)。虽然给药方式之间的系统差异通常较小,但SF-36的所有八个量表都存在大量非系统差异(平均绝对差异得分在10.8至30.1之间)。情感角色功能、身体角色功能、社会功能和身体疼痛方面的差异最大;这四个量表的相关性也较低至中等(0.33至0.58)。
两种给药方式可能不会产生可互换的结果。研究人员在对老年患者混合使用给药方式时应谨慎。