Study on Attitudes towards Deprescribing among Elderly Patients with Chronic Diseases in Several Communities of Chongqing / 中国药房

OBJECTIVE:To provide reference for promoting smoothly implementation of deprescribing. METHODS:A total of 335 elderly patients with chronic disease were randomly selected from 4 communities and 9 village clinic of a Chongqing community health service center. Questionnaire survey was conducted about general information of respondents,disease and drug use condition and attitude to deprescribing by using Australian Patients'Attitudes Towards Deprescribing questionnaire as reference. The results of questionnaire survey were analyzed statistically. The cognitive function was assessed by Hastgawa Dementia Scale. The degree of weakness was evaluated by Chinese edition of Edmonton Frail Scale. The quality of life was evaluated by Chinese edition of European Five Dimensional Health (EQ-5D) Scale. RESULTS:Totally 311 valid questionnaires were obtained,with effective recovery rate of 92.8％. Overall,311 participants were recruited,with a median age of 70 years,5 types of median disease (hypertension was most common) and 5 types of median medication (mainly calcium channel blocker and non-insulin hypoglycemic agent);54.7％(170 cases)participants took multiple drugs. The attitudes towards deprescribing were that 39.5％ of respondents believed that they took too many drugs;73.9％ had a desire to reduce their drugs;83.6％ reported that they would be willing to reduce drugs if their doctor said it was possible. The patients taking multiple drugs preferred to use less drugs (P=0.001) and reduce current drugs (P=0.001),and were more willing to reduce drug cost by reducing drug use;they were also more worried about drug side effects than those without taking multiple drugs (P=0.005). CONCLUSIONS:The phenomenon of elderly chronic diseases patients with multiple diseases and multiple drug use are popular in community. It is necessary to simpilfy prescription. Most elderly patients would like to reduce their medications if doctors say it is possible;the patients with multiple drug use are more willing to simplify prescription than those without multiple drug use.

Exploring Medicine Information Needs of Hypertensive Patients Using Short Message Service.

Aims: To explore the pattern of unmet medicine information needs of hypertensive patients on long term therapy and their attitude to use of SMS (mobile phone short message service) for medicine information exchange with hospital pharmacists. Sample: 117 hypertensive patients on long term therapy who had been accessing care for at least one year. Study Design: An exploratory medicine information exchange programme followed by a cross-sectional survey. Place and Duration of Study: Outpatient Clinic of Department of Cardiology at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between October, 2010and May, 2011. Methods: Patients were prompted with SMS twice weekly for 5-8 months for use of their medication with advice to send their medicine information needs to the hospital pharmacist. Received messages were subjected to content analysis to identify their themes. A semi-structured questionnaire was used to explore patient attitude to the use of SMS. The 17-item questionnaire was designed on a 5-point Likert scale for responses with weights of 0-4. Data obtained were analysed using both descriptive and inferential statistics. These include frequencies and mean of weighted averages (MWA); tests of relationships, associations and of differences in means. Results: A total of 63 SMS texts were received from the respondents and 44% of the messages expressed medicine information needs. Majority of the enquiries were related to indications and adverse effects. The patients’ attitude to the use of SMS for medicine information exchange with pharmacists was generally positive (MWA=3.13) with no significant demographic effects. Some (46%) of the patients called for institutionalisation of the medicine information exchange programme. Conclusion: The unmet medicine information needs of chronic hypertensive patients in the study were related mainly to indications and side effects of prescribed and nonprescribed medications and the patients clamoured for use of SMS in redressing the anomaly.

Patients' Attitudes Toward the Involvement of Medical Students in Their Care / 한국의학교육

PURPOSE: There is a negative assumption that patients are reluctant to have medical students be involved in their care. In response, students refrain from revealing to the patients that they are students in order that they may participate in patient-care. The purpose of this study is to determine whether patients' attitudes towards medical students is negative or positive, and to explore the level acceptable by patients of students' involvement in their care. METHODS: The study subjects were 90 inpatients in two university hospitals. The questionnaire consisted of 12 items covering patient's attitude toward student involvement in their care, acceptable patient-care activities in which students could be involved, and preference for being told if caregiver is a medical student. RESULTS: Patients' attitudes towards students' participation in their care were relatively more favorable than expected. 46.8% of patients reported that they would permit students to be involved up to and including simple non-invasive techniques. 76.2% of patients stated that they would allow students to participate in their future in-hospital care. Most patients preferred knowing that the caregiver was a medical student. CONCLUSION: The results of this study are reassuring. A higher than expected percentage of patients surveyed disclosed that they would accept medical students being involved in their care. Medical educators should provide a safe environment for medical students to be able to tell the patients, "I am a student doctor".

Communication Effects of Written Drug Information on Patient Attitude, especially Those of Risk Information / 薬剤疫学

Objective : To evaluate communication effects of the intervention by written risk information on prescribed drugs and explore the influencing factors.<BR>Design : A randomized prospective controlled trial.<BR>Setting : An outpatient unit in a medical center.<BR>Patients : 243 outpatients prescribed antihypertensive drugs.<BR>Intervention : Patients were randomized into either the study or control group. The study group received sheets showing risk information in addition to drug's name and efficacy while the control group received those without risk information. Patients were requested to complete a questionnaire before and 1 month after receiving information.<BR>Main outcome measures : The communication effects, defined in terms of patient satisfaction, helpfulness of the sheets, reassurance about taking drugs and compliance evaluated by himself.<BR>Results : Of 243 patients, 123 completed the second questionnaire. Of those 123, the study group patients were significantly more satisfied (p=0.035). For other 3 measures, there were no significant differences between the study and control groups. But almost all patients regarded the sheets helpful. After receiving the sheets with or without risk information, 67 (61.5%, 109 answered) were reassured and the compliance was said to be improved with 32 (28.1%, 114 answered).<BR>From the exploratory analysis of 112 patients having completed both questionnaires, patients who evaluated the sheets helpful tended to be more reassured. The compliance of patients who were reassured tended to be better.<BR>Conclusion : Patients regarded the written drug information as a helpful medium and were more satisfied with risk information. Irrespective of whether risk information was included, reassurance and better compliance were attained by the written drug information.