背景:患者对处方药标签内容和格式的偏好(PML,即,在分配时放置在药物瓶/包装上的贴纸标签)已经得到了广泛的研究。然而,由于空间限制,适应PML的所有偏好是不切实际的。了解患者如何优先考虑PML的内容和格式属性,可以在PML空间限制范围内进行改进。
目的:我们的目标是:(1)使用最佳-最差尺度(BWS),确定药物相关内容属性的排序,优先考虑PML。(2)使用离散选择实验(DCE)确定合并到PML上时格式属性的相对重要性,从新加坡老年患者的角度来看。
方法:属性由我们之前的定性研究和PML最佳实践指南提供。对于BWS组件,评估的内容属性是指征,预防措施,相互作用或配对药物,食物说明,副作用,有效期,错过了剂量行动,所有这些目前在新加坡都没有法律授权的PML。使用BWS对象案例对内容属性进行排名。对于DCE组件,在一系列问题中,参与者每次被要求在两个PML选项之间进行选择,剂量频率说明的表述各不相同,字体大小,剂量的介绍,预防措施的介绍,和字体颜色的预防措施。混合logit模型估计了格式属性级别的相对效用,启用格式属性的重要性得分的计算。
结果:该研究招募了280名参与者(平均年龄:68.8±5.4岁)。三个最喜欢的内容属性是指示,预防措施和相互作用或配对药物。排名前三的格式偏好是剂量频率说明的表格风格呈现,大字体大小和红色的注意事项。
结论:医疗机构应考虑根据老年患者表达的主要内容和格式偏好来改善其PML。研究中采用的方法也可用于使其他患者教育材料的内容和格式与患者偏好保持一致。
Patient preferences for the content and format of prescription medication labels (PMLs, i.e., sticker labels placed on medication bottles/packets at dispensing) have been extensively studied. However, accommodating all preferences on PMLs is impractical due to space limitations. Understanding how patients prioritise the content and format attributes of PMLs can inform improvements while working within PML space constraints.
We aimed to (1) identify a ranking of medication-related content attributes to be prioritised on PMLs using best-worst scaling (BWS), and (2) determine the relative importance of format attributes when incorporated onto PMLs using discrete choice experiment (DCE), from the perspective of older adult patients in Singapore.
Attributes were informed by our prior qualitative
study and PML best practice guidelines. For the BWS component, the assessed content attributes were indication, precautions, interaction or paired medicines, food instructions, side effects, expiry date, and missed dose action, all of which are currently not legally mandated on PMLs in Singapore. A BWS object case was used to rank the content attributes. For the DCE component, in a series of questions, participants were asked to choose between two PML options each time, that varied in the presentation of dosage-frequency instructions, font size, presentation of dosage, presentation of precautions, and font colour of precautions. A mixed logit model estimated the relative utilities of format attribute levels, enabling the calculation of importance scores of the format attributes.
The
study recruited 280 participants (mean age: 68.8 ± 5.4 years). The three most-preferred content attributes were indication, precautions and interaction or paired medicines. The top three format preferences were tabular style presentation of dosage-frequency instructions, large font size and precautions in red colour.
Healthcare institutions should consider improving their PMLs based on the leading content and format preferences voiced by older adult patients. The methodology adopted in the
study can also be used for aligning the content and format of other patient education materials with patient preferences.