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      Development and evaluation of user-tested Thai patient information leaflets for non-steroidal anti-inflammatory drugs: Effect on patients’ knowledge

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          Abstract

          Introduction

          Thai patients do not routinely receive patient information leaflets (PILs) with medicines, so awareness of safety issues is low. This study aimed: i) to develop Thai PILs for NSAIDs and subject these to user-testing, and ii) to assess the potential value of PILs from the patient perspective and effect on patient knowledge.

          Methods

          Four PILs for NSAIDs were developed and subjected to multiple rounds of user-testing by the general public. Self-administered questionnaires were distributed to orthopaedic out-patients prescribed one of these NSAIDs, assessing knowledge before and after providing a PIL. The follow-up questionnaire also sought use of and views on the PILs using a visual analogue scale (VAS).

          Results

          1,240 baseline questionnaires were completed; only 13.5% of patients had good knowledge. 688 patients returned follow-up questionnaires (55.5%), of whom75% had good knowledge. In patients completing both questionnaires, mean knowledge score increased from 6.22±1.40 to 8.42±1.41 (p<0.001). Patients with high educational levels had high baseline scores (OR = 2.728) and showed greatest improvement in knowledge (OR = 5.628). 90% (625) of follow-up respondents indicated they read all information in the PILs. All also agreed that these PILs should distributed to all patients taking NSAIDs. The median VAS score for usefulness was 9.3 (IQR 8.6–10.0).

          Conclusions

          User-testing of PILs was feasible in a Thai population and enabled the development of acceptable and desirable PILs. PILs could improve patients' knowledge about their medicine, particularly among those with higher educational level. User-tested PILS could meet the need for more written medicine information.

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          Most cited references 42

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          Health information needs, sources, and barriers of primary care patients to achieve patient-centered care: A literature review

          To synthesize findings from previous studies assessing information needs of primary care patients on the Internet and other information sources in a primary care setting. A systematic review of studies was conducted with a comprehensive search in multiple databases including OVID MEDLINE, CINAHL, and Scopus. The most common information needs among patients were information about an illness or medical condition and treatment methods, while the most common information sources were the Internet and patients' physicians. Overall, patients tend to prefer the Internet for the ease of access to information, while they trust their physicians more for their clinical expertise and experience. Barriers to information access via the Internet include the following: socio-demographic variables such as age, ethnicity, income, education, and occupation; information search skills; and reliability of health information.
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            A systematic review of quantitative and qualitative research on the role and effectiveness of written information available to patients about individual medicines

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              Adverse drug events resulting from patient errors in older adults.

              To characterize the types of patient-related errors that lead to adverse drug events (ADEs) and identify patients at high risk of such errors. A subanalysis within a cohort study of Medicare enrollees. A large multispecialty group practice. Thirty thousand Medicare enrollees followed over a 12-month period. Primary outcomes were ADEs, defined as injuries due to a medication, and potential ADEs, defined as medication errors with the potential to cause an injury. The subset of these events that were related to patient errors was identified. The majority of patient errors leading to adverse events (n=129) occurred in administering the medication (31.8%), modifying the medication regimen (41.9%), or not following clinical advice about medication use (21.7%). Patient-related errors most often involved hypoglycemic medications (28.7%), cardiovascular medications (21.7%), anticoagulants (18.6%), or diuretics (10.1%). Patients with medication errors did not differ from a comparison group in age or sex but were taking more regularly scheduled medications (compared with 0-2 medications, odds ratio (OR) for 3-4 medications=2.0, 95% confidence interval (CI)=0.9-4.2; OR for 5-6 medications=3.1, 95% CI=1.5-7.0; OR for >or=7 medications=3.3, 95% CI=1.5-7.0). The strongest association was with the Charlson Comorbidity Index (compared with a score of 0, OR for a score of 1-2=3.8, 95% CI=2.1-7.0; OR for a score of 3-4=8.6, 95% CI=4.3-17.0; OR for a score of >or=5=15.0, 95% CI=6.5-34.5). The medication regimens of older adults present a range of difficulties with the potential for harm. Strategies are needed that specifically address the management of complex drug regimens.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: MethodologyRole: Project administrationRole: SoftwareRole: Writing – original draft
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                9 January 2019
                2019
                : 14
                : 1
                Affiliations
                [1 ] Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
                [2 ] Faculty of Pharmacy, Thammasat University, Pathumthani, Thailand
                [3 ] Medway School of Pharmacy, Universities of Greenwich and Kent, Kent, United Kingdom
                Universiteit van Amsterdam, NETHERLANDS
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                [¤]

                Current address: Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok, Thailand

                Article
                PONE-D-18-26367
                10.1371/journal.pone.0210395
                6326498
                30625196
                © 2019 Jarernsiripornkul et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 0, Tables: 5, Pages: 15
                Product
                Funding
                Funded by: the Khon Kaen University Integrate Multidisciplinary Research Cluster under Grant
                Award ID: MIH-2554-Ph.D-07
                Award Recipient :
                Funded by: the Graduate School of Khon Kaen University under Grant)
                Award ID: 55222103
                Award Recipient :
                This work was supported by the Khon Kaen University Integrate Multidisciplinary Research Cluster under Grant [number MIH-2554-Ph.D-07], received by Miss Pacharaporn Phueanpinit and the Graduate School of Khon Kaen University under Grant [number 55222103], received by Miss Pacharaporn Phueanpinit. However, the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and health sciences
                Pharmacology
                Drugs
                Analgesics
                NSAIDs
                Medicine and health sciences
                Pain management
                Analgesics
                NSAIDs
                People and Places
                Population Groupings
                Ethnicities
                Thai People
                Social Sciences
                Sociology
                Education
                Educational Attainment
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Medicine and Health Sciences
                Health Care
                Patients
                Medicine and Health Sciences
                Pharmacology
                Drugs
                People and Places
                Geographical Locations
                Asia
                Thailand
                Social Sciences
                Sociology
                Education
                Schools
                Custom metadata
                All relevant data are within the manuscript and its Supporting Information files.

                Uncategorized

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