ABSTRACT
Abstract Background In the Philippines, the exact prevalence of Parkinson's disease (PD) has not yet been determined. Although cases can be extrapolated from medical registries, this method may undermine actual case rates. A reliable screening tool for PD is essential for a timely diagnosis and community-based epidemiological studies. The most widely used screening questionnaire for PD diagnosis was developed by Tanner et al., which consists of nine questions about the motor symptoms of PD. Although this questionnaire has been translated to several languages, the translated version must be validated for use in our local setting. Objective To determine the validity of the Cebuano version of a PD screening questionnaire. Method The questionnaire was translated from English to Cebuano by a hired language specialist. Each item was supplied with ayes, no, ordon't know answer. A total of 73 patients with PD and 244 control subjects completed the study. Results The overall Cronbach alpha for internal consistency of the questionnaire was 0.9410. The item ontremor had the highest sensitivity (97.26%), while the item onproblems with buttoning had the highest specificity (100.00%). A cut-off score ≥ 3 obtained the best Youden index (99.18%), with a sensitivity of 100.00% and a specificity of 99.18%. The questionnaire had an almost perfect predictive ability to diagnose PD (AUC of 0.9994). Conclusion The translated version of the Tanner questionnaire is a validated instrument to identify PD in a literate Cebuano population.
Resumo Antedecentes Nas Filipinas, a prevalência exata da doença de Parkinson (DP) ainda não foi determinada. Embora os casos possam ser extrapolados dos registros médicos, esse método pode prejudicar as taxas reais de casos. Uma ferramenta de triagem confiável para DP é essencial para um diagnóstico oportuno e estudos epidemiológicos baseados na comunidade. O questionário de triagem mais utilizado para o diagnóstico da DP foi desenvolvido por Tanner et al., que consiste em nove questões sobre os sintomas motores da DP. Embora este questionário tenha sido traduzido para vários idiomas, a versão traduzida deve ser validada para uso em nosso meio. Objetivo Determinar a validade da versão Cebuano de um questionário de triagem de DP. Métodos O questionário foi traduzido do inglês para o cebuano por um especialista em idiomas contratado. Cada item foi fornecido com uma resposta "sim", "não" ou "não sei". Um total de 73 pacientes com DP e 244 controles completaram o estudo. Resultados Em geral o alfa de Cronbach para consistência interna do questionário foi de 0,9410. O item "tremor" teve a maior sensibilidade (97,26%), enquanto o item "problemas com abotoamento" teve a maior especificidade (100,00%). Um escore de corte > 3 obteve o melhor índice de Youden (99,18%), com sensibilidade de 100,00% e especificidade de 99,18%. O questionário teve uma capacidade preditiva quase perfeita para diagnosticar DP (AUC de 0,9994). Conclusão A versão traduzida do questionário de Tanner é um instrumento validado para identificar a DP em uma população cebuana alfabetizada.
ABSTRACT
BACKGROUND: Patients' understanding of prescriptions is one of the key elements to a successful treatment. In the Philippines, patients do not have the benefit of having pharmacists explaining the prescription when they purchase their medicines. Inability to understand and follow prescriptions may, therefore, contribute to medication non-compliance, which leads to unwanted disease progression, complications, and even premature death. OBJECTIVE: To assess the understanding of Filipino patients of prescriptions given by their doctors and to identify the factors that significantly affect their understanding. METHODS: In total, 392 individuals, using purposive sampling, were interviewed from pharmacies around a government hospital outpatient department (OPD), a private hospital OPD, private clinics, and local health centers in Manila, Philippines. The patients' knowledge about the proper intake of the prescribed drugs was assessed and the factors that were deemed to affect their understanding were then identified. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated according to the various study factors included in the study to measure the association between each study variable and incomplete understanding of prescriptions. A multivariate logistics regression model was constructed applying a stepwise procedure to enter variables in the model. RESULTS: Among the 392 participants, 219(55.9%) patients had an incomplete understanding of prescriptions, 176 (44.9%) were not able to identify the correct dose of the prescribed drug, followed by 103(26.3%) who were not able to identify the name of the drug. Multivariate logistics regression analysis identified only three independent variables to be statistically significant predisposing factors to incomplete understanding of prescriptions: non-legible prescriptions (OR=4.598, 95% CI 2.671-7.913), prescriptions with an incomplete set of written instructions (OR=2.108, 95% CI 1.234-3.601), and patient having had no previous use of the prescribed drug or a similar drug (OR=2.126, 95% CI 1.361-3.320). CONCLUSIONS: The results of this study suggest that physicians play an important role in promoting complete understanding of prescriptions. Non-legible prescriptions and prescriptions with an incomplete set of written instructions were found to significantly affect patients' understanding of prescriptions. Physicians should also be more careful in instructing patients who will take the prescribed medications for the first time. These information may be used to enhance better understanding of prescriptions among patients and thereby prevent non-compliance and treatment failure.