RESUMO
BACKGROUND: Our study was conducted to determine the prevalence of drug-related problems (DRPs) in outpatient prescriptions, the impact of DRPs on treatment efficacy, safety, and cost, and the determinants of DRPs in prescribing for pediatric outpatients in Vietnam. METHODS: A retrospective cross-sectional study was conducted on pediatric outpatients at a pediatric hospital in Can Tho, Vietnam. DRPs were classified according to the Pharmaceutical Care Network Europe classification (PCNE) of 2020. The study determined prevalence of DRPs and their impacts on efficacy, safety, and cost. Multivariate regression was used to identify the determinants of DRPs. RESULTS: The study included 4339 patients (mean age 4.3, 55.8% male), with a total of 3994 DRPs, averaging 0.92 DRP/prescription. The proportion of prescriptions with at least one DRP was 65.7%. DRPs included inappropriate drug selection (35.6%), wrong time of dosing relative to meals (35.6%), inappropriate dosage form (9.3%), inappropriate indication (7.1%), and drug-drug interactions (0.3%). The consensus of experts was average when evaluating each aspect of efficiency reduction, safety reduction, and treatment cost increase, with Fleiss' coefficients of 0.558, 0.511, and 0.541, respectively (p < 0.001). Regarding prescriptions, 50.1% were assessed as reducing safety. The figures for increased costs and decreased treatment effectiveness were 29.0% and 23.9%, respectively. Patients who were ≤2 years old were more likely to have DRPs than patients aged 2 to 6 years old (OR = 0.696; 95% CI = 0.599-0.809) and patients aged over 6 years old (OR = 0.801; 95% CI = 0.672-0.955). Patients who had respiratory system disease were more likely to have DRPs than patients suffering from other diseases (OR = 0.715; 95% CI = 0.607-0.843). Patients with comorbidities were less likely to have DRPs than patients with no comorbidities (OR = 1.421; 95% CI = 1.219-1.655). Patients prescribed ≥5 drugs were more likely to have DRPs than patients who took fewer drugs (OR = 3.677; 95% CI = 2.907-4.650). CONCLUSION: The proportion of prescriptions in at least one DRP was quite high. Further studies should evaluate clinical significance and appropriate interventions, such as providing drug information and consulting doctors about DRPs.
RESUMO
OBJECTIVE: To translate and cross-culturally adapt the Brief Illness Perception Questionnaire (BIPQ) and the Beliefs about Medicines Questionnaire (BMQ) into Vietnamese. METHODS: We followed the guideline by Beaton et al. (2000 & 2007). Stage I: two translators (informed and uninformed) translated the questionnaires. Stage II: the translations were synthesised. Stage III: back translation was performed by two translators fluent in both Vietnamese and English but naïve to the outcome measurement. Stage IV: seven experts reached consensus on the pre-final Vietnamese version (BIPQ-V and BMQ-V). Stage V: field test of the questionnaires on 16 twelve-year-old students and 31 Vietnamese patients. In addition, we determined the internal consistency and test-retest reliability of the questionnaires in 34 Vietnamese patients with acute coronary syndrome. RESULTS: All experts agreed that there was semantic, idiomatic, experiential and conceptual equivalence between the original and pre-final Vietnamese versions of the BIPQ and BMQ. Cronbach's alpha coefficients of the internal consistency were acceptable for the BMQ-V Specific-Necessity (0.64), BMQ-V Specific-Concerns (0.62) and BMQ-V General-Harm (0.60), with the exception of BMQ-V General-Overuse (0.27). Intra-class correlation coefficients of the test-retest reliability were acceptable for the subscales of BMQ-V (range: 0.77-0.86), and BIPQ-V items (range: 0.62-0.85) with the exception of BIPQ-V 1 (0.44, 95% CI -014 to 0.72) and BIPQ-V 4 (0.57, 95% CI 0.22-0.81). CONCLUSIONS: The Vietnamese version of BIPQ and BMQ are reliable tools to assess illness perceptions and beliefs about medicines of patients with acute coronary syndrome. Psychometric properties of these questionnaires should be tested in different patient populations.
OBJECTIF: Traduire en vietnamien et adapter culturellement le Bref Questionnaire sur la Perception de la Maladie (BIPQ) et le Questionnaire sur les Croyances relatives aux Médicaments (BMQ). MÉTHODES: Nous avons suivi les directives de Beaton et al. (2000 et 2007). Etape I: deux traducteurs (informés et non informés) ont traduit les questionnaires. Etape II: les traductions ont été synthétisées. Etape III: une re-traduction a été effectuée par deux traducteurs parlant couramment le vietnamien et l'anglais mais naïfs sur la mesure des résultats. Etape IV: sept experts sont parvenus à un consensus sur la version vietnamienne pré-finale (BIPQ-V et BMQ-V). Etape V: test sur le terrain des questionnaires sur 16 étudiants de 12 ans et 31 patients vietnamiens. En outre, nous avons déterminé la cohérence interne et la fiabilité du test/re-test des questionnaires chez 34 patients vietnamiens atteints de syndrome coronarien aigu. RÉSULTATS: Tous les experts ont convenu qu'il existait une équivalence sémantique, idiomatique, expérientielle et conceptuelle entre les versions originales et pré-finale vietnamiennes du BIPQ et du BMQ. Les coefficients alpha de cohérence interne de Cronbach étaient acceptables pour la nécessité spécifique du BMQ-V (0,64), les préoccupations spécifiques du BMQ-V (0,62) et la nocivité générale du BMQ-V (0,60), à l'exception de la qualité générale du BMQ-V (0,27). Les coefficients de corrélation intra-classe de la fiabilité du test/re-test étaient acceptables pour les sous-échelles de BMQ-V (plage: 0,77-0,86) et les éléments du BIPQ-V (plage: 0,62-0,85) à l'exception du BIPQ-V 1 (0,44; IC95%: −014-0,72) et du BIPQ-V 4 (0,57; IC95%: 0,22-0,81). CONCLUSIONS: Les versions vietnamiennes du BIPQ et du BMQ constituent des outils fiables pour évaluer les perceptions relatives à la maladie et les croyances concernant les médicaments destinés aux patients atteints du syndrome coronarien aigu. Les propriétés psychométriques de ces questionnaires doivent être testées dans différentes populations de patients.
