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1.
J Korean Med Sci ; 35(14): e92, 2020 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-32281312

RESUMO

BACKGROUND: Non-adherence to oral maintenance therapy in adolescents with inflammatory bowel disease (IBD) is a significant healthcare problem. Knowledge of the prescribed medication can increase medication adherence. We aimed to investigate the relationship between medication adherence and disease-related knowledge of pediatric and adolescent patients with IBD. METHODS: We conducted a "pop quiz" to investigate the disease-related knowledge of pediatric patients with IBD who were followed-up at our institution and reviewed their medical records, including data on sex, diagnosis, age at diagnosis, and disease duration. Medication adherence was evaluated by the doctor in charge, and ≥ 80% of patients constituted the "good adherence group." RESULTS: Of 93 patients, 59 (63.4%) were males, and 78 (83.9%) had Crohn's disease. The mean age at diagnosis was 13.8 ± 2.8 years; mean follow-up duration, 4.8 ± 3.4 years; and mean patient age, 18.6 ± 3.7 years. Only 65 patients (69.9%) knew the exact name of the medication they were currently taking, and 34 (36.6%) knew the correct dose. Only 15 patients (16.1%) knew the name of the medications they were previously taking. A total of 64 patients (66.8%) showed an adherence rate of 80% for the weekly prescribed oral medication. The patients in the poor adherence group were significantly older than those in the good adherence group (P = 0.035). The number of hospitalizations per year was statistically higher in the good adherence group (P = 0.024). The proportion of patients who knew the names of the medications they were previously taking and were aware of the side effects of the medications was significantly higher in the good adherence group (P = 0.008 and P = 0.020, respectively). CONCLUSION: Adolescent IBD patients have lower oral medication adherence. Knowledge of the prescribed medications taken previously, and the adverse effects of these medications are associated with good adherence. IBD specialists should educate the patients regarding the disease and about their medication.


Assuntos
Doenças Inflamatórias Intestinais , Adesão à Medicação , Conhecimento do Paciente sobre a Medicação , Adolescente , Criança , Feminino , Humanos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Masculino , Adulto Jovem
2.
Medicine (Baltimore) ; 99(12): e19490, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195948

RESUMO

INTRODUCTION: Contraceptive use and sexual health behavior remain a prominent public health concern in South Africa (SA). Despite many government interventions, unintended pregnancies and termination of pregnancies remain relatively high. This review aimed to map evidence on factors influencing contraceptive use and sexual behavior in SA. METHODS: We conducted a scoping review guided by Arksey and O'Malley's framework. We searched for articles from the following databases: PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host, Union Catalogue of Theses and Dissertations (UCTD) and SA ePublications via SABINET Online and World Cat Dissertations, Theses via OCLC and Google Scholar. Studies published from January 1990 to March 2018 were included. We used the Population, Concept, and Context (PCC) framework and the PRISMA chart to report the screening of results. The Mixed Method Appraisal Tool (MMAT) version 11 and ACCODS tools were used to determine the quality of the included studies. RESULTS: A total of 2030 articles were identified by our search criteria for title screening. Only 21 studies met our inclusion criteria and were included in quality assessment stage. We found that knowledge of a contraceptive method, length of a relationship, sexual debut, age difference between partners availability of a contraceptive method, long waiting hours, and nurse's attitudes toward human immunodeficiency virus (HIV) positive or younger clients predict whether or not women use a contraceptive method or improve sexual behavior. CONCLUSION: There remains a necessity for improving educational programs aimed at transferring knowledge on contraceptives and sexual behavior to both women and their male counterparts, alongside the public health systems' improvements.


Assuntos
Comportamento Contraceptivo/tendências , Anticoncepção/psicologia , Conhecimento do Paciente sobre a Medicação/estatística & dados numéricos , Comportamento Sexual/psicologia , Aborto Induzido/estatística & dados numéricos , Adolescente , Adulto , Comportamento Contraceptivo/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Gravidez , Gravidez não Planejada/psicologia , Parceiros Sexuais/psicologia , África do Sul/epidemiologia , Adulto Jovem
3.
Am J Nurs ; 120(2): 36-42, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31977416

RESUMO

Polypharmacy, the use by a patient of multiple medications, contributes to adverse drug events, hospitalizations, geriatric syndromes, and increased health care costs. In the United States, polypharmacy is increasingly widespread, particularly among community-dwelling adults over age 62. In 2005-2006, 31% of such adults used five or more prescription drugs and 8.4% used medication combinations associated with potential interactions. By 2010-2011, 36% used five or more prescription drugs and 15% used potentially problematic drug combinations. Reducing the dangers of polypharmacy, however, requires clinicians to broaden their focus, considering not only the number of drugs a patient takes, but also the prescription of potentially inappropriate medications and potential prescribing omissions. This article explores the factors that contribute to polypharmacy and discusses its negative physiological, psychological, and economic effects. It also describes strategies for reducing polypharmacy, including both "explicit" approaches, which are grounded in the findings of literature reviews and expert opinion, and "implicit" approaches, which are based on the provider's interpretation of clinical data and the patient's medication regimen.


Assuntos
Desprescrições , Vida Independente/estatística & dados numéricos , Polimedicação , Padrões de Prática Médica , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Múltiplas Afecções Crônicas/tratamento farmacológico , Conhecimento do Paciente sobre a Medicação/enfermagem , Lista de Medicamentos Potencialmente Inapropriados , Estados Unidos
4.
Cien Saude Colet ; 24(9): 3539-3550, 2019 Sep 09.
Artigo em Português | MEDLINE | ID: mdl-31508771

RESUMO

This work cross-culturally adapted the Spanish questionnaire `Patients' knowledge about their medications ("Conocimiento del Paciente sobre sus Medicamentos" - CPM-ES-ES) for use in Brazil. It measures the level of medication knowledge by means of 11 questions. Eighty patients ≥ 80 years were investigated and in 39 cases the caregivers were interviewed. The evaluation of conceptual and item equivalences considered the concept of knowledge and the questions that assess it as pertinent. Semantic equivalence was obtained by the correspondence in the denotative and connotative meaning of items. The study of measurement equivalence included factorial analysis and the calculation of validity and reliability estimates. As with the original questionnaire, principal component analysis identified 4 components, however, in 2 of them there were differences regarding included items. One question was removed from this analysis due to its sample inadequacy. Medication knowledge was correlated with medication regimen complexity r = -.22, p = .046. Medication knowledge of antihypertensives was correlated with their adherence r = .70, p < .001, and blood pressure control rb = .46, p = .029. The adapted version revealed functional equivalence, therefore it can be used in the Brazilian context.


Assuntos
Cuidadores/estatística & dados numéricos , Comparação Transcultural , Conhecimento do Paciente sobre a Medicação/estatística & dados numéricos , Inquéritos e Questionários , Idoso de 80 Anos ou mais , Anti-Hipertensivos/administração & dosagem , Brasil , Feminino , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Análise de Componente Principal , Reprodutibilidade dos Testes
6.
Int J Clin Pharm ; 41(4): 972-980, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31197547

RESUMO

Background Mental health problems are common in people with substance misuse problems. However, there is a paucity of evidence regarding prescribing of psychotropic medications for people with comorbid mental health and substance misuse problems. Objective To explore the views of service users attending an addiction service on the appropriateness of psychotropic medications prescribed for their co-existing mental health problems. Setting A specialist addiction service in the North of England. Method A phenomenological approach was adopted. Semi-structured interviews were conducted with twelve service users. Data were analysed using thematic framework analysis. Main outcome measure Service users' views concerning the appropriateness of their prescribed psychotropic medications. Results The following themes captured service users' views on the appropriateness of their medications: benefits from medicines, entitlement to medicines, and assessment and review. Service users mostly described benefits from their medications (including those prescribed outside guideline recommendations) and there was also an awareness of the adverse effects they experienced from them. It appears that people with substance misuse problems have a particularly strong sense of their own needs and seek to influence prescribing decisions. Service users further described varied practices regarding assessment and review of their medications with evidence of regular reviews while others identified suboptimal or inadequate practices. Conclusion Most service users described improved functioning as a result of their prescribed psychotropic medications. Prescriptions that are inappropriate in terms of their usual indications may well be justified if they assist in stabilising service users and moving them on to recovery.


Assuntos
Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Conhecimento do Paciente sobre a Medicação , Pacientes/psicologia , Psicotrópicos/uso terapêutico , Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Idoso , Comorbidade , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Int J Clin Pharm ; 41(4): 1021-1030, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31104187

RESUMO

Background When women are in a condition that requires medicines during pregnancy they have to balance the health benefits of the medical treatment against the potential risk of harming their unborn child. Too high teratogenic risk perceptions among pregnant women can lead them to stop taking the medicine, worsening the symptoms for the mother and even harming their foetus. Many women today who use over-the-counter and prescribed medicines have been shown to change their medical behaviour when they become pregnant. Objective To explore in depth the perceptions of medication use among women during their pregnancy. Setting The Capital Region of Denmark. Methods Participants were recruited from social network groups on Facebook and from participants in lectures and antenatal classes for pregnant women in two hospitals. Two focus groups interviews and three individual semi-structured interviews were conducted. The interview guides were based on existing literature and relatively unstructured, with an emphasis on open-ended questions. Interview transcripts were analysed using the phenomenological approach of meaning condensation. Main Outcome measure Pregnant women's' perceptions of medicine including aspects related to their safety feeling of medicines and perceived support from health care professionals. Results The women believed that it is less safe to take medicines during pregnancy, largely due to the risk of the child getting a disease in the future, but also due to the risk of malformation. Lack of clinical tests and uncertainty about how the unborn child reacts to medications were reported causes of these concerns. Most participants were concerned about using medicines and avoided them if possible, including over-the counter medicines. Conversations with physicians had a calming effect although the physicians appeared to be unclear in their guidance regarding dietary supplements. Some women received conflicting information on the Internet. Several suggestions were made about how to reduce uncertainties about the safety of taking medicines during pregnancy. Conclusion Many pregnant women are concerned about how to use medicines. To reduce these concerns and ensure the appropriate use of medicines during pregnancy, initiatives are needed to strengthen evidence-based advice from health care professionals, especially during the first trimester.


Assuntos
Medicamentos sem Prescrição/uso terapêutico , Conhecimento do Paciente sobre a Medicação , Gestantes/psicologia , Medicamentos sob Prescrição/uso terapêutico , Adulto , Dinamarca , Feminino , Grupos Focais , Humanos , Gravidez , Adulto Jovem
9.
Am J Health Syst Pharm ; 76(Supplement_2): S49-S54, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-30854542

RESUMO

PURPOSE: The primary objective of this project was to evaluate an existing interprofessional, nonmalignant pain service by measuring the difference in patient pain scores (numeric rating scale-11) before and after a pharmacist-led pain education class and medication therapy management (MTM) visit. Secondary objectives included determining the percentage of pharmacist recommendations approved, patient satisfaction, and difference in immediate release (IR) and extended release (ER) opioid use before and after enrollment. METHODS: Baseline data were obtained from a retrospective chart review. Enrolled patients attended an educational pain class with the pharmacist. At the MTM visit with the pharmacist 3-14 days after the initial education class, the patient's pain score was assessed along with his/her medication use, and a care plan was developed and forwarded to the referring provider for implementation. Three months after the pain class and participation in the MTM visit, patients were contacted via telephone to complete a survey. The survey questions assessed patient satisfaction with the pain education program, their current pain score, and their knowledge of information covered during the pain class. RESULTS: Patients reported an average preenrollment pain score of 8.3/10 (n = 39) and a post-survey pain score of 5.6/10 (n = 39). The IR opioid use averaged 19.7 morphine equivalent daily dose (MEDD) at enrollment and decreased by 40% to 11.8 MEDD. The provider approval rate of the pharmacist-recommended interventions ranged from 80% to 92%, depending on the predesignated disease state category. CONCLUSION: An interprofessional, nonmalignant-pain service including a pharmacist-led class resulted in a decrease in average pain scores and MEDD in an underserved population.


Assuntos
Dor Crônica/terapia , Clínicas de Dor/organização & administração , Manejo da Dor/métodos , Educação de Pacientes como Assunto , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Dor Crônica/diagnóstico , Centros Comunitários de Saúde/organização & administração , Feminino , Humanos , Masculino , Conduta do Tratamento Medicamentoso/organização & administração , Pessoa de Meia-Idade , Ohio , Transtornos Relacionados ao Uso de Opioides/etiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Medição da Dor/estatística & dados numéricos , Conhecimento do Paciente sobre a Medicação , Satisfação do Paciente/estatística & dados numéricos , Farmacêuticos/organização & administração , Papel Profissional , Avaliação de Programas e Projetos de Saúde , Encaminhamento e Consulta/organização & administração , Estudos Retrospectivos , Inquéritos e Questionários/estatística & dados numéricos , Telefone , Populações Vulneráveis/estatística & dados numéricos
10.
Kardiol Pol ; 77(4): 437-444, 2019 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-30835335

RESUMO

BACKGROUND The Jessa Atrial Fibrillation Knowledge Questionnaire (JAKQ) was successfully used to assess knowledge gaps in patients with atrial fibrillation (AF). AIMS To evaluate the regional differences among Polish patients in their awareness of AF diagnosis and oral anticoagulation use. METHODS A total of 1583 patients with AF at a median (IQR) age of 72 (66-79) years completed the JAKQ in 3 cardiology centers (center I, Kraków; center II, Torun; center III, Kielce) from January 2017 to June 2018. The final analysis included 1525 patients, 32.9% were on vitamin K antagonists (VKAs) and 67.1% on non-VKA oral anticoagulants (NOACs), that is, rivaroxaban and dabigatran (28.9% each), and apixaban (9.3%). RESULTS The mean (SD) score on the JAKQ was 55.5% (18.4%) with better results among patients on VKAs compared with NOACs (58% [18.3%] vs 54.3% [18.4%]; P = 0.0002) with time from AF diagnosis more than 12 months (57.4% [17.5%] vs 50% [19.9%]; P <0.0001). There was a significant difference in the knowledge scores between the 3 centers (I, 59.5%; II, 48.5%; III, 54.3%; P <0.0001). In all centers the number of correct answers correlated inversely with patient's age (r = -0.20; P <0.0001). NOACs were more frequently used in center III. The percentage of correct responses was lower in patients on reduced NOAC doses (35.4% of patients on NOACs), compared with the full-dose NOAC groups in center I (56.9% vs 62.5%; P = 0.012) and II (48.1% vs 56.2%; P = 0.003). CONCLUSIONS Patients from a high-volume academic center showed better knowledge than their peers from district hospitals. There are large regional differences in prescription patterns of oral anticoagulants, including the preferred NOAC.


Assuntos
Anticoagulantes/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Gerenciamento Clínico , Educação de Pacientes como Assunto , Conhecimento do Paciente sobre a Medicação , Administração Oral , Idoso , Anticoagulantes/administração & dosagem , Dabigatrana/administração & dosagem , Dabigatrana/uso terapêutico , Feminino , Hospitais de Distrito , Hospitais de Ensino , Humanos , Masculino , Polônia , Pirazóis/administração & dosagem , Pirazóis/uso terapêutico , Piridonas/administração & dosagem , Piridonas/uso terapêutico , Rivaroxabana/administração & dosagem , Rivaroxabana/uso terapêutico , Inquéritos e Questionários
11.
Turk J Med Sci ; 49(1): 198-205, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30764598

RESUMO

Background/aim: Widespread use of antiretroviral treatment (ART) has led to decrease in the incidence of HIV/AIDS-related mortality. Besides the availability of ART, medication adherence is essential for treatment success. There is a scarcity of data reported from Turkey regarding ART adherence among people living with HIV/AIDS (PLWHA). Therefore, this study was undertaken to determine medication adherence and related factors among PLWHA in Turkey. Materials and methods: The sample consisted of 158 PLWHA, who were being followed up at Infectious Diseases Outpatient Clinic of Hacettepe University Hospital. Data were collected using an individual questionnaire and the Turkish version of the Morisky Medication Adherence Scale. Results: The median patient age was 38 years, 80.4% were male, and 51.3% were married. The median duration of both HIV infection and ART was 3 years. Sixty-one percent used two drug regimens. Sixty-one percent were highly adherent to ART while 37.9% were moderately adherent. The absence/presence of social support resources, disease duration, ART duration, and being informed about the ART regimen were statistically associated with medication adherence. Conclusion: Our results suggest that medication adherence is excellent among Turkish PLWHA. Interventions, including effective social support, and continuous counseling about ART, might further boost the adherence of PLWHA


Assuntos
Síndrome de Imunodeficiência Adquirida , Antirretrovirais/uso terapêutico , Infecções por HIV , Adesão à Medicação , Conhecimento do Paciente sobre a Medicação , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/psicologia , Adulto , Atitude Frente a Saúde , Aconselhamento/métodos , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Estado Civil , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde , Conhecimento do Paciente sobre a Medicação/enfermagem , Conhecimento do Paciente sobre a Medicação/estatística & dados numéricos , Apoio Social , Turquia/epidemiologia
14.
PLoS One ; 14(1): e0209366, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30625176

RESUMO

PURPOSE: To examine whether applying case management in general practices reduces thromboembolic events requiring hospitalization and major bleeding events (combined primary outcome). Secondary endpoints were mortality, frequency and duration of hospitalization, severe treatment interactions, adverse events, quality of anticoagulation, health-related quality of life and intervention costs, patients' assessment of chronic illness care, self-reported adherence to medication, GP and HCA knowledge, patient knowledge and satisfaction with shared decision-making. METHODS: Cluster-randomized controlled trial undertaken at 52 general practices in Germany with adult patients with a long-term indication for oral anticoagulation. The complex intervention included training for healthcare assistants, information and quality circles for general practitioners and 24 months of case management for patients. Assessment was after 12 and 24 months. The intention-to-treat population included all randomized practices and patients, while the per-protocol analysis included only those that received treatment without major protocol violations. RESULTS: The mean (SD) age of the 736 patients was 73.5 (9.4) years and 597 (81.1%) had atrial fibrillation. After 24 months, the primary endpoint had occurred in 40 (11.0%) intervention and 48 (12.9%) control patients (hazard ratio 0.83, 95% CI 0.55 to 1.25; P = .37). Patients' perceived quality of care, their knowledge, and HCAs' knowledge, had improved significantly at 24 months. The other secondary endpoints did not differ between groups. In the intervention group, hospital admissions were significantly reduced in patients that received treatment without major protocol deviations. CONCLUSIONS: Even though the main outcomes did not differ significantly, the intervention appears to have positively influenced several process parameters under 'real-world conditions'.


Assuntos
Administração de Caso , Fibrinolíticos/uso terapêutico , Atenção Primária à Saúde , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Análise por Conglomerados , Determinação de Ponto Final , Feminino , Fibrinolíticos/administração & dosagem , Fibrinolíticos/efeitos adversos , Medicina Geral , Alemanha , Hemorragia/etiologia , Hospitalização , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Conhecimento do Paciente sobre a Medicação , Satisfação do Paciente , Qualidade de Vida , Tromboembolia/etiologia , Fatores de Tempo
15.
Pol Arch Intern Med ; 129(1): 28-35, 2019 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-30516757

RESUMO

INTRODUCTION The current awareness of venous thromboembolism (VTE) and knowledge of thromboprophylaxis among patients receiving oral anticoagulation therapy (OAC) are insufficient. OBJECTIVES We sought to develop and evaluate the usefulness of the Jessa AF Knowledge Questionnaire (JAKQ), modified for VTE patients. PATIENTS AND METHODS Consecutive patients at least 1 month since the VTE event (n = 273, mean [SD] age, 51 [17] years; 52.7%, women; 55.9%, unprovoked event) were enrolled to the study. RESULTS The median percentage of correct responses was 64.2% (interquartile range, 53%-73%; minimum, 12%; maximum, 100%). Younger patients had better knowledge about VTE in general, including a higher proportion of correct responses to the question about the definition of PE (71.4% vs 57.7%, P = 0.03), about the possible consequence of DVT, including PE (81.1% vs 62%, P = 0.001) and VTE risk related to long travels (78.1% vs 59.2%, P = 0.002). There was no difference in overall scoring between patients taking new oral anticoagulants and those taking vitamin K antagonists (mean [SD], 64.1% [16.3%] vs 63.9% [13.8%], respectively, P = 0.7). Regardless of the type of anticoagulants, 39.3% of patients knew that VTE is not always symptomatic, 33.6% knew what to do when they missed an OAC dose, and 50% did not know which painkillers are the safest in combination with anticoagulants. Education applied in 27 patients resulted in an increase in the median percentage of correct responses from 60% to 80% (P = 0.0001). CONCLUSIONS Knowledge on VTE and anticoagulation is suboptimal among patients on VKA and NOACs. Education of VTE patients should be improved especially in older individuals on NOACs.


Assuntos
Anticoagulantes/uso terapêutico , Conhecimento do Paciente sobre a Medicação , Tromboembolia Venosa/prevenção & controle , Administração Oral , Adulto , Idoso , Anticoagulantes/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
16.
Photodermatol Photoimmunol Photomed ; 35(3): 141-147, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30383894

RESUMO

BACKGROUND: Insufficient understanding of sunscreen labeling terminology is a barrier to effective use. The Food and Drug Administration (FDA) issued the "final rule" on sunscreen labeling in 2011, in an effort to promote effective usage. However, relatively little is known about patient knowledge of sunscreen labeling terminology. This study assesses the sunscreen labeling knowledge of dermatology patients, with an emphasis on understanding of the FDA-mandated wording. METHODS: A validated survey was administered to consecutive dermatology office patients. Respondents answered questions about sunscreen use practices, sunscreen knowledge, and demographics. To assess their sunscreen knowledge, they responded to questions on the concepts of sun protection factor, broad-spectrum, and waterproof. RESULTS: A total of 334 patients completed surveys. Only 8.7% of patients correctly answered all three questions related to sunscreen labeling terminology. Patients with a personal history of skin cancer were more likely to answer more than half of the questions correctly (P = 0.004). Older persons and those with darker skin types were most likely to answer all questions incorrectly. CONCLUSION: General understanding of sunscreen labeling was poor, and a minority of consumers comprehended the key features of sunscreen labeling. This knowledge gap appeared to be slightly smaller in the subpopulation of patients with a personal history of skin cancer.


Assuntos
Rotulagem de Medicamentos , Conhecimento do Paciente sobre a Medicação , Protetores Solares , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terminologia como Assunto , Estados Unidos , United States Food and Drug Administration
17.
Res Social Adm Pharm ; 15(4): 469-473, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29803539

RESUMO

BACKGROUND: Prompt management of side effects is critical to supporting adherence to antiretroviral (ARV) medication. OBJECTIVE: This study examines the impact of presenting side effect information using simple text combined with pictograms on sustained knowledge of ARV side effects over three months. METHOD: Previously designed side effect pictograms, combined with simple text, were incorporated into a side effects panel within an ARV information leaflet. In a randomised controlled study, 116 limited literacy HIV patients taking ARVs were randomly allocated to either control (standard care) or intervention groups (standard care plus illustrated information). Side effect knowledge was assessed at baseline, and intervention patients received the illustrated leaflet. Knowledge was re-tested at one and three months. Interpretation of side effect pictograms was evaluated at one month. RESULTS: In intervention patients, mean side effect knowledge increased from 45.9% (baseline) to 95.7% (three months; p<0.0001), and pictogram interpretation was good. Knowledge did not change significantly in the control group. All found the pictograms clear and useful, and endorsed their routine use. CONCLUSIONS: Providing patients with simple written information containing pictograms on ARV side effects significantly improved side effect knowledge, sustained over time, in limited literacy, rural South African HIV patients.


Assuntos
Antirretrovirais/efeitos adversos , Rotulagem de Medicamentos , Infecções por HIV/tratamento farmacológico , Conhecimento do Paciente sobre a Medicação , Adolescente , Adulto , Compreensão , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , África do Sul , Adulto Jovem
19.
PLoS One ; 13(11): e0207996, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30496232

RESUMO

INTRODUCTION: Exploiting information in health-related social media services is of great interest for patients, researchers and medical companies. The challenge is, however, to provide easy, quick and relevant access to the vast amount of information that is available. One step towards facilitating information access to online health data is opinion mining. Even though the classification of patient opinions into positive and negative has been previously tackled, most works make use of machine learning methods and bags of words. Our first contribution is an extensive evaluation of different features, including lexical, syntactic, semantic, network-based, sentiment-based and word embeddings features to represent patient-authored texts for polarity classification. The second contribution of this work is the study of polar facts (i.e. objective information with polar connotations). Traditionally, the presence of polar facts has been neglected and research in polarity classification has been bounded to opinionated texts. We demonstrate the existence and importance of polar facts for the polarity classification of health information. MATERIAL AND METHODS: We annotate a set of more than 3500 posts to online health forums of breast cancer, crohn and different allergies, respectively. Each sentence in a post is manually labeled as "experience", "fact" or "opinion", and as "positive", "negative" and "neutral". Using this data, we train different machine learning algorithms and compare traditional bags of words representations with word embeddings in combination with lexical, syntactic, semantic, network-based and emotional properties of texts to automatically classify patient-authored contents into positive, negative and neutral. Beside, we experiment with a combination of textual and semantic representations by generating concept embeddings using the UMLS Metathesaurus. RESULTS: We reach two main results: first, we find that it is possible to predict polarity of patient-authored contents with a very high accuracy (≈ 70 percent) using word embeddings, and that this considerably outperforms more traditional representations like bags of words; and second, when dealing with medical information, negative and positive facts (i.e. objective information) are nearly as frequent as negative and positive opinions and experiences (i.e. subjective information), and their importance for polarity classification is crucial.


Assuntos
Conhecimento do Paciente sobre a Medicação/classificação , Participação do Paciente/psicologia , Algoritmos , Atitude , Informação de Saúde ao Consumidor , Emoções , Humanos , Internet , Idioma , Aprendizado de Máquina , Redes Sociais Online , Sistemas On-Line , Web Semântica , Semântica , Telemedicina
20.
PLoS One ; 13(11): e0208004, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30496233

RESUMO

BACKGROUND: Adequate disease and treatment-related risk knowledge of people with Multiple Sclerosis (pwMS) is a prerequisite for informed choices in medical encounters. Previous work showed that MS risk knowledge is low among pwMS and role preferences are different in Italy and Germany. OBJECTIVE: We investigated the level of risk knowledge and role preferences in 8 countries and assessed putative variables associated with risk knowledge. METHODS: An online-survey was performed based on the Risk knowledge questionnaire for people with relapsing-remitting MS (RIKNO 2.0), the electronic Control Preference Scale (eCPS), and other patient questionnaires. Inclusion criteria of participants were: (1) age ≥18 years, (2) a diagnosis of relapsing-remitting MS (RRMS), (3) being in a decision making process for a disease modifying drug. RESULTS: Of 1939 participants from Germany, Italy, the Netherlands, Serbia, Spain and Turkey, 986 (51%) (mean age 38.6 years [range 18-67], 77% women, 7.8 years of disease duration) completed the RIKNO 2.0, with a mean of 41% correct answers. There were less than 50 participants in the UK and Estonia and data were not analysed. Risk knowledge differed across countries (p < 0.001). Variables significantly associated with higher risk knowledge were higher education (p < 0.001), previous experience with disease modifying drugs (p = 0.001), correct answer to a medical data interpretation question (p < 0.001), while higher fear for wheelchair dependency was negatively associated to risk knowledge (p = 0.001). CONCLUSION: MS risk knowledge was overall low and differed across participating countries. These data indicate that information is an unmet need of most pwMS.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Esclerose Múltipla Recidivante-Remitente/etnologia , Adolescente , Adulto , Idoso , Tomada de Decisões , Europa (Continente) , Feminino , Humanos , Consentimento Livre e Esclarecido , Conhecimento , Masculino , Competência Mental , Pessoa de Meia-Idade , Esclerose Múltipla/psicologia , Esclerose Múltipla Recidivante-Remitente/psicologia , Conhecimento do Paciente sobre a Medicação/tendências , Risco , Medição de Risco , Sérvia , Inquéritos e Questionários , Turquia
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