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Scott M, Watermeyer J, Wessels TM. A balancing act: Non-directive communication, risk perceptions, and meeting patient needs in genetic counseling: A South African case study. J Genet Couns 2024; 33:462-472. [PMID: 37323090 DOI: 10.1002/jgc4.1741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Abstract
Genetic counseling (GC) traditionally follows a non-directive counseling approach. Although a cornerstone of GC teaching and theory, there has been debate on whether GC is, can be, or should be a patient-led service due to challenges in practice, as well as the advancement and complexity of genetic testing. Personal risk perceptions and patient expectations within particular contexts may further affect how genetic counselors discuss risk information, even while attempting to remain neutral. Less is known about the process of GC communication in non-Western settings. This paper presents empirical evidence from a South African prenatal GC consultation where tensions become apparent due to differing risk perceptions and expectations between a genetic counselor and a patient, which ultimately impacts non-directive communication practice. The case study forms part of a larger qualitative study focusing on risk and uncertainty communication within GC consultations in Cape Town, South Africa. A blended sociolinguistic approach drawing on principles of conversation analysis (CA) and theme-orientated discourse analysis (TODA) provides evidence of the complexity of imparting risk information and challenging patients to reflect on their decision-making, whilst refraining from sharing personal risk perceptions during everyday practice. The case study demonstrates how a genetic counselor may become implicitly and explicitly directive in their communication approach within the same consult which may reveal their personal risk perceptions on the matter discussed. In addition, the case study reveals how a genetic counselor may grapple with the dilemma of honoring the non-directive guidelines of the profession, whilst simultaneously supporting a patient who requests advice. The ongoing debate on non-directive counseling, decision-making, and patient care in GC is important for the reflection and development of the profession to understand how to assist and support patients facing sensitive and difficult decisions, in a meaningful, and contextually-tailored manner.
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Affiliation(s)
- Megan Scott
- The Health Communication Research Unit (HCRU), School of Human & Community Development, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer Watermeyer
- The Health Communication Research Unit (HCRU), School of Human & Community Development, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
| | - Tina-Marie Wessels
- Division of Human Genetics, Department of Pathology, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
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Sabblah GT, van Hunsel F, Taxis K, Duwiejua M, Seaneke SK, van Puijenbroek E. Medication errors by caregivers in the homes of children discharged from a pediatric department in Ghana. Ther Adv Drug Saf 2024; 15:20420986231225850. [PMID: 38293565 PMCID: PMC10823839 DOI: 10.1177/20420986231225850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/24/2023] [Indexed: 02/01/2024] Open
Abstract
Background Medication errors (MEs) by caregivers at home are a cause of morbidity and mortality, shortly after discharge from the hospital. Objectives The objective of this study was to determine the rate and types of MEs at the homes of children discharged from a hospital in Ghana and to explore the factors associated with these errors. Design This was a cross-sectional study of infants and children discharged from the hospital to review medication administration practices. Methods Caregivers of children discharged from the hospital after at least 24 hours of admission were interviewed at their homes about medication administration practices. The study assessed potential harm associated with MEs made by caregivers using the Harm Associated with Medication Error Classification tool. The Least Absolute Shrinkage and Selection Operator regression were used to identify the variables associated with MEs. Results A total of 95 children (mean age: 28.6 months, 52.6% female) and their caregivers were included. Overall, 65 (68.4%) children experienced one or more MEs. Out of a total of 232 medications reviewed, 102 (44.0%) (95% CI: 37.6-50.4) were associated with a ME. The top two errors, wrong time errors and errors in the frequency of dosing were, 45.1% and 21.6%, respectively. Understanding the information on the disease condition being treated and the medicines dispensed was associated with committing fewer MEs. The number of medicines prescribed was associated with a higher likelihood of MEs. Out of 102 MEs, 48 (47.1%) were assessed as posing potentially no harm, 26 (25.5%) minor harm, 15 (14.7%) moderate harm, and 13 (12.8%) serious harm to the patients. Importantly, none of the MEs were assessed as posing potentially severe or life-threatening harm to the patients. Conclusion MEs in children following discharge are high, and systems should be developed to prevent these errors.
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Affiliation(s)
- George Tsey Sabblah
- Food and Drugs Authority, P.O. Box CT 2783, Cantonments, Accra, Ghana
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Florence van Hunsel
- Netherlands Pharmacovigilance Centre Lareb, ‘s-Hertogenbosch, The Netherlands
| | - Katja Taxis
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Mahama Duwiejua
- School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | | | - Eugène van Puijenbroek
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
- Netherlands Pharmacovigilance Centre Lareb, ‘s-Hertogenbosch, The Netherlands
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Nualdaisri P, Corlett SA, Akaso I, Katusiime B, Kitutu FE, Chua SS, Krska J. Patients' Experiences and Preferences for Medicine Information: An International Comparison Between Malaysia, Thailand, Uganda, and England. Patient Prefer Adherence 2024; 18:239-248. [PMID: 38283625 PMCID: PMC10821663 DOI: 10.2147/ppa.s444891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/11/2024] [Indexed: 01/30/2024] Open
Abstract
Background Verbal and written medicine information are available to the public but the quality, ease of access, ease of understanding and use of these resources varies greatly between countries. Timely access to quality medicine information is essential to support patient safety. Objective This international cross-sectional survey, conducted in low-to high-income countries, aimed to compare experiences of and preferences for medicine information sources among respondents with recent medicine use. Methods The survey was originally developed in England (Kent), then adapted and translated for use in southern Thailand (Songkhla), Malaysia (Klang Valley), and central Uganda (Kampala). Data were analysed using simple descriptive statistics and Chi-squared tests. Results A total 1588 respondents were involved in the study. Community pharmacies were the primary source of medicines in all four countries (40.7 to 65.3%). Most respondents (1460; 92%) had received at least one form of information with their medicine, but provision of written medicine information (WMI) varied between countries. A manufacturer's leaflet was the most frequent information source for patients in England, while verbal information was common in Thailand, Malaysia and Uganda. There was commonality across countries in the desire for verbal information with or without WMI (1330; 84.8%); aspects of medicine information wanted most frequently were instructions on medicine use (98.3%), indication (98.2%), name (94.4%) and possible side effects (94.3%); and the importance of providing leaflets with all medicines (87.5%). Fewer than 10% in Uganda would use internet based WMI, compared to between 20% and 55% elsewhere. Conclusion Preferences for medicine information are similar across countries: verbal information is seen as most desirable, and the most wanted aspects of information are common internationally. Accessibility and understandability are key influences on preferred information sources. In-country regulations and practices should ensure that all medicine users can access the information necessary to maximise safe medicine use.
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Affiliation(s)
- Pitchaya Nualdaisri
- Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Thailand
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK
| | - Sarah A Corlett
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK
- Pharmacy Department, Medway Foundation NHS Trust, Kent, UK
| | - Immaculate Akaso
- Department of Pharmacy, School of Health Sciences, Makerere University, Kampala, Uganda
| | - Barbra Katusiime
- School of Life Sciences, Pharmacy and Chemistry, Department of Pharmacy, Kingston University, London, UK
| | - Freddy Eric Kitutu
- Department of Pharmacy, School of Health Sciences, Makerere University, Kampala, Uganda
| | - Siew Siang Chua
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, Malaysia
| | - Janet Krska
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK
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Ikejezie J, Adebusoye B, Ekezie W, Langley T, Lewis S, Phalkey R. Modifiable risk factors for diphtheria: A systematic review and meta-analysis. GLOBAL EPIDEMIOLOGY 2023; 5:100100. [PMID: 37638375 PMCID: PMC10445968 DOI: 10.1016/j.gloepi.2023.100100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
Objective To identify modifiable risk factors for diphtheria and assess their strengths of association with the disease. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Electronic databases and grey literature were searched from inception until January 2023. Studies had to report on diphtheria cases and estimates of association for at least one potential risk factor or sufficient data to calculate these. The quality of non-ecological studies was assessed using the Newcastle-Ottawa Scale (NOS), while the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Results The search yielded 37,705 papers, of which 29 were ultimately included. All the non-ecological studies were of moderate to high quality. Meta-analysis of 20 studies identified three factors increasing the risk of diphtheria: incomplete vaccination (<3 doses) (pooled odds ratio (POR) = 2.2, 95% confidence interval (CI) = 1.4-3.4); contact with a person with skin lesions (POR = 4.8, 95% CI = 2.1-10.9); and low knowledge of diphtheria (POR = 2.4, 95% CI = 1.2-4.7). Contact with a case of diphtheria; sharing a bed or bedroom; sharing utensils, cups, and glasses; infrequent bathing; and low parental education were associated with diphtheria in multiple studies. Evidence for other factors was inconclusive. The quality of evidence was low or very low for all the risk factors. Conclusions Findings from the review suggest that countries seeking to control diphtheria need to strengthen surveillance, improve vaccination coverage, and increase people's knowledge of the disease. Future research should focus on understudied or inconclusive risk factors.
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Affiliation(s)
- Juniorcaius Ikejezie
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK
| | - Busola Adebusoye
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK
| | - Winifred Ekezie
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK
| | - Tessa Langley
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK
| | - Sarah Lewis
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK
| | - Revati Phalkey
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK
- Climate Change and Health Unit, UK Health Security Agency, London, United Kingdom
- Heidelberg Institute of Global Health, University of Heidelberg, Germany
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Dowse R, Okeyo S, Sikhondze S, Khumalo N. Methodology of an approach for modifying pictograms showing medication side effects or indication. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:147-157. [PMID: 37401879 DOI: 10.1080/17538068.2022.2056292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
BACKGROUND Pictograms may improve user-friendliness and comprehension of written or verbal health information. This paper describes a method to modify pictograms to improve their visual clarity, appeal and overall interpretive complexity in order to reduce the cognitive load on the viewer during comprehension. METHODOLOGY Nine pictograms previously tested for comprehension were selected for modification. In phase 1, two participatory design workshops were conducted with (a) three limited literacy, first-language isiXhosa-speaking participants and (b) four university students. Opinions and ideas for improving interpretation were discussed. In phase 2, revised visuals were generated by the graphic artist and subsequently modified in an intensive, multistage, iterative process. RESULTS As no guidelines for pictogram modification exist, a modification schema was developed based on the process described in this study. Adopting a participatory approach combined with a systematic, intensive modification process enabled the opinions and preferences of the end-users to be heard, ensuring cultural relevance and contextual familiarity of the final product. Careful scrutiny of all individual visual elements of each pictogram, considerations of space, and thickness of lines all contributed to improving the legibility of visuals. CONCLUSIONS The methodology for designing and modifying existing pictograms using a participatory process resulted in nine final pictograms that were approved by all design team members and considered good candidates for subsequent comprehension testing. The methodological schema presented in this paper provides guidance to researchers intending to design or modify pictograms.
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Affiliation(s)
- Ros Dowse
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Sam Okeyo
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Simise Sikhondze
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Nosihle Khumalo
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
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Ståhlgren M, Forsell C, Drott J. Information needs in patients with bladder cancer undergoing radical cystectomy – A qualitative review with thematic synthesis. Eur J Oncol Nurs 2022; 61:102231. [DOI: 10.1016/j.ejon.2022.102231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/11/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022]
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Sun H, Li J, Cheng Y, Pan X, Shen L, Hua W. Developing a framework for understanding health information behavior change from avoidance to acquisition: a grounded theory exploration. BMC Public Health 2022; 22:1115. [PMID: 35658937 PMCID: PMC9166210 DOI: 10.1186/s12889-022-13522-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 05/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health information avoidance is common in real life, but because it is not always conducive to health promotion and maintenance, people often actively switch to health information acquisition. Understanding this process of active change can facilitate intervention in unreasonable avoidance behaviors. However, studies so far have mostly focused on why and how avoidance takes place, little is known about the process of active change from avoidance to acquisition. We thus use a grounded theory approach (GT) to explore how the active change takes place, and to generate a grounded theoretical framework capable of illustrating stages and influencing factors involved in the active change process. METHODS Straussian grounded theory (Corbin & Strauss, 2015) was used to analyze data collected through semi-structured interviews with 30 adults (14 in good health, 11 with disease, 5 in other health status) who had experienced health information behavior change from avoidance to acquisition. These interviews focused on how the change occurred and what effected the change. RESULTS The core category of Health Information Avoidance Change and 12 categories were identified and integrated to form a theoretical framework termed the Health Information Avoidance Change Model (HIACM). This model describes the process using five non-linear stage variables (initiation, preparation, action, maintenance, and abandonment) and seven moderating factor variables (cognitive change, social stimulus, beliefs and attitudes, intrapsychic literacy, social resources, information source, time and material resources). CONCLUSIONS HIACM can be used to explain the process of active change from health information avoidance to health information acquisition. HIAC is a non-linear and holistic process, and it is necessary to dynamically analyze the impact of relevant factors and take targeted intervention measures in stages. HIAC is usually not only an individual behavior, but also a socialized behavior requiring the collaboration of individuals, families, health information providers, healthcare providers, and governments.
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Affiliation(s)
- Haixia Sun
- Institute of Medical Information & Library, Chinese Academy of Medical Sciences / Peking Union Medical College, Beijing, China
| | - Jiao Li
- Institute of Medical Information & Library, Chinese Academy of Medical Sciences / Peking Union Medical College, Beijing, China
| | - Ying Cheng
- School of Information Management, Nanjing University, Nanjing, China
| | - Xuelian Pan
- School of Information Management, Nanjing University, Nanjing, China
| | - Liu Shen
- Institute of Medical Information & Library, Chinese Academy of Medical Sciences / Peking Union Medical College, Beijing, China
| | - Weina Hua
- School of Information Management, Nanjing University, Nanjing, China
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So J, Ahn J, Guan M. Beyond Depth and Breadth: Taking "Types" of Health Information Sought into Consideration with Cluster Analysis. JOURNAL OF HEALTH COMMUNICATION 2022; 27:27-36. [PMID: 35081009 DOI: 10.1080/10810730.2022.2029978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Online health information-seeking behavior (OHIS) has been typically operationalized in an aggregate form representing either depth (e.g., how long) or breadth (e.g., how much) of seeking, which is irrespective of what types of information are sought. Recognizing limitations of such practice, this research employs cluster analysis to reflect the content and types of health information sought in studying OHIS. Three online studies providing participants with opportunities to actually seek information about meningitis (Study 1; N = 408), Alzheimer's disease (Study 2; N = 190), and cancer (Study 3; N = 208) recorded the participants' information-seeking activities unobtrusively. Across the three studies, cluster analysis identified three common clusters representing distinctive information-seeking patterns (i.e., combinations of different types of information sought): One cluster sought information on "overview," the second one focused on "protection" information, and the third cluster sought "all" types of information provided. The relative preference for these types of information was predicted by several antecedents of information-seeking behavior proposed in Comprehensive Model of Information Seeking (CMIS) including age, fear, self- and response-efficacy. The findings demonstrate the utility of taking the actual content or types of health information sought into consideration and suggest several fruitful avenues it paves for future research on OHIS.
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Affiliation(s)
- Jiyeon So
- Department of Communication, Yonsei University, Seoul, Republic of Korea
| | - Jeongyoun Ahn
- Department of Industrial and Systems Engineering, KAIST, Daejeon, Republic of Korea
| | - Mengfei Guan
- Department of Communication, University of Arkansas, Fayetteville, Arkansas, USA
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Prata RA, Bicudo TB, Silva JBD, Avila MAGD. Letramento em saúde de adolescentes na pandemia de COVID-19: revisão integrativa. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0956pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivo: analisar a produção científica sobre o letramento em saúde (LS) de adolescentes durante a pandemia de COVID-19. Método: revisão integrativa, nas bases de dados MEDLINE, LILACS, CINAHL e Web of Science, entre março de 2020 e agosto de 2021. Foram incluídos artigos originais nos idiomas inglês, espanhol e português. Resultados: dos 65 estudos encontrados na busca, oito foram incluídos para análise, não havendo nenhuma publicação no Brasil, com cinco publicações no ano de 2021, predominância na língua inglesa (n=7) e todos classificados com nível de evidência VI. Dos instrumentos utilizados, eHealth literacy foi a ferramenta mais aplicada (n=2). Televisão, família e internet foram apontadas como as principais fontes de informações de saúde durante a pandemia. Considerações finais: a literatura sinalizou que o LS pode interferir na tomada de decisão dos adolescentes e que um baixo LS pode levar a decisões e ações de exposição física e mental dos adolescentes.
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Prata RA, Bicudo TB, Silva JBD, Avila MAGD. Health literacy of adolescents in the COVID-19 pandemic: an integrative review. Rev Bras Enferm 2022; 75Suppl 1:e20210956. [DOI: 10.1590/0034-7167-2021-0956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/11/2022] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT Objective: to analyze the scientific production on health literacy (HL) of adolescents during the COVID-19 pandemic. Method: an integrative review, in the MEDLINE, LILACS, CINAHL and Web of Science databases, between March 2020 and August 2021. Original articles in English, Spanish and Portuguese were included. Results: of the 65 studies found in the search, eight were included for analysis, with no publication in Brazil, with five publications in 2021, predominantly in English (n=7) and all classified with level of evidence VI. Of the instruments used, eHealth literacy was the most applied instrument (n=2). Television, family and the internet were identified as the main sources of health information during the pandemic. Final considerations: the literature has indicated that HL can interfere with adolescents’ decision making and that a low HL can lead to decisions and physical and mental exposure actions of adolescents.
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The Effectiveness and Value of Written Medicine Information Across Asia and Africa: Systematic Review. Drug Saf 2021; 44:1283-1295. [PMID: 34623626 DOI: 10.1007/s40264-021-01114-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Abstract
Reviews on the role, value, effectiveness and desirable content of written medicine information (WMI) mostly include studies from high-income countries. We reviewed studies from Africa and Asia published between January 2004 and December 2019 to determine (1) the effect of WMI on knowledge and behaviour and (2) whether patients value WMI and their preferences for WMI. We included 16 intervention studies involving almost 3500 participants and 27 surveys of patients/public totalling over 11,000 people. Both the quality of the intervention studies and the reporting quality varied. Surveys were mostly localised, many with inadequate sampling strategies, and hence, were poorly representative of wider populations. However, most included a high proportion of participants with low educational levels. Most of the intervention studies reported significant improvements in knowledge and/or adherence after provision of WMI. Many utilised specially developed WMI in local languages, enhanced by pictograms. Provision of verbal information in addition to WMI showed variable impact. The proportion of people who read WMI, used as an indicator of its value, was reported in 15 surveys, with an overall figure of 74%. The most desirable aspects of WMI reported in 12 studies were indication, side effects, dose/instructions for use, contraindications, precautions and interactions. Nine studies reported local language was desirable. The studies suggest that WMI can improve both knowledge and adherence and is highly valued by people in many countries across Africa and Asia. Mechanisms should be considered by regulatory authorities and manufacturers to facilitate the provision of leaflets in local languages using simple terminology, perhaps enhanced by pictograms.This study is registered with PROSPERO, registration number: CRD42019127001.
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Nualdaisri P, Corlett SA, Krska J. Provision and Need for Medicine Information in Asia and Africa: A Scoping Review of the Literature. Drug Saf 2021; 44:421-437. [PMID: 33666901 PMCID: PMC7994240 DOI: 10.1007/s40264-020-01038-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 11/23/2022]
Abstract
Published reviews of written medicine information (WMI) have mainly drawn on studies published in high-income countries, including very few Asian or African studies. We therefore set out to scope the research literature to determine the extent and type of studies concerning WMI for patients/consumers across these two continents. We sought empirical studies published between January 2004 and December 2019, conducted in any Asian or African country, as defined by the United Nations, in English or with an English abstract. The majority of the 923 papers identified were from high-income countries. We retained 26 papers from Africa and 99 from Asia. Most African studies (n = 20) involved patients in the development of PILs, in the assessment of the effectiveness of PILs or in surveys. In contrast, the highest proportion of Asian studies concerned the content of WMI (n = 42). WMI is desired, but needs to be in local languages, and there needs to be more use made of pre-tested pictograms. Existing WMI frequently does not meet local regulatory requirements, particularly locally manufactured products. A number of studies reported potentially positive impacts of providing WMI on knowledge and medicine use behaviours. Provision of medicine information is essential for safe use of medicines in all countries. Internationally agreed guidelines, incorporating good design principles, are needed to ensure the optimal content and design of WMI. The World Health Organization should support African and Asian regulatory bodies to share best practice in relation to WMI for patients/consumers and to develop and implement pan-continental guidelines that take into account consumer needs and preferences.
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Affiliation(s)
- Pitchaya Nualdaisri
- Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Thailand
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK
| | - Sarah A Corlett
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK
| | - Janet Krska
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK.
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Jose J. A healthcare professional's understanding of the medication information-seeking behaviour of patients: significance in the digital era. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2020; 28:299-300. [PMID: 32643795 DOI: 10.1111/ijpp.12655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 01/11/2023]
Affiliation(s)
- Jimmy Jose
- School of Pharmacy, University of Nizwa, Nizwa, Sultanate of Oman
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Tusubira AK, Akiteng AR, Nakirya BD, Nalwoga R, Ssinabulya I, Nalwadda CK, Schwartz JI. Accessing medicines for non-communicable diseases: Patients and health care workers' experiences at public and private health facilities in Uganda. PLoS One 2020; 15:e0235696. [PMID: 32634164 PMCID: PMC7340292 DOI: 10.1371/journal.pone.0235696] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/20/2020] [Indexed: 12/15/2022] Open
Abstract
Background Non-communicable diseases (NCDs) are increasingly prevalent in low- and middle-income countries. Successful management requires consistent access to appropriate medicines. Availability of NCD medicines is generally low, especially in the public sector, however, little is known about other factors affecting access. We explored barriers and facilitators of access to medicines for diabetes and hypertension at public and private health facilities in Uganda. Methods We conducted a qualitative descriptive study at six public hospitals and five private health facilities in different regions of Uganda. Data collection included 36 in-depth interviews and 14 focus group discussions (n = 128) among purposively selected adult outpatients with diabetes and/or hypertension and 26 key informant interviews with healthcare workers and patient association leaders. Transcripts were coded and emerging themes identified using the Framework method. Results Four main themes emerged: Stocking of medicines and supplies, Financial factors, Individual behaviour and attitudes, and Service delivery at health facilities. Stocking of medicines and supplies mainly presented barriers to access at public facilities including frequent stockouts, failure to stock certain medicines and low quality brands often rejected by patients. Financial factors, especially high cost of medicines and limited insurance coverage, were barriers in private facilities. Free service provision was a facilitator at public facilities. Patients’ confusion resulting from mixed messages and their preference for herbal treatments were cross-sector barriers. While flexibility in NCD service provision was a facilitator at private facilities, provider burnout and limited operating hours were barriers in public facilities. Patient-driven associations exist at some public facilities and help mitigate inadequate medicine stock. Conclusion Access to NCD medicines in Uganda is influenced by both health system and patient factors. Some factors are sector-specific, while others cross-cutting between public and private sectors. Due to commonalities in barriers, potential strategies for overcoming them may include patient-driven associations, public-private partnerships, and multi-modal health education platforms.
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Affiliation(s)
- Andrew K. Tusubira
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- * E-mail:
| | - Ann R. Akiteng
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
| | - Brenda D. Nakirya
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
| | - Ritah Nalwoga
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
| | - Isaac Ssinabulya
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Christine K. Nalwadda
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences Makerere University, Kampala, Uganda
| | - Jeremy I. Schwartz
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- Section of General Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America
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15
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The cost and quality of life impact of glaucoma in Tanzania: An observational study. PLoS One 2020; 15:e0232796. [PMID: 32479506 PMCID: PMC7263578 DOI: 10.1371/journal.pone.0232796] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/21/2020] [Indexed: 11/19/2022] Open
Abstract
AIMS To determine the cost and quality of life impact imposed by glaucoma in Tanzania, East Africa. METHODS An expert panel of eye health professionals was convened to agree current glaucoma practice in Tanzania. In addition a structured patient survey was developed and administered. Supplemental cost and quality of life information was collected using cost questionnaires and validated quality of life measures, including the EQ5D and VFQ-25. RESULTS Key findings include following. Non-adherence is a major issue, especially in rural settings where over 50% of the patients may fail to return for review. Whilst medical therapy is overwhelmingly the first line treatment, the cost of maintaining this represents up to 25% of a patient's income. There is an impact of glaucoma on patients general well-being as determined by the EQ-5D and more tellingly on visual function with particular impact on role limitations as determined by the VF25. Despite our sample being taken in a private clinic and thus containing a much larger proportion of professionals than the general population, one third of the population earned Tanzanian Shillings (TZS) 170,000 per month which is below the minimum wage. CONCLUSION These findings are of great importance for health care planners seeking to determine cost-effective, acceptable methods of both identifying and treating this major cause of preventable blindness.
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16
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Zimmerman MS, Shaw G. Health information seeking behaviour: a concept analysis. Health Info Libr J 2020; 37:173-191. [PMID: 32052549 DOI: 10.1111/hir.12287] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/04/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND In 2007, Lambert and Loiselle conducted an extensive concept analysis of the term health information seeking behaviour (HISB) to examine the concept's level of maturity and critically analyse its characteristics. Since their groundbreaking work, HISB has evolved with the proliferation of ICTs. The Internet is now a common and often preferred medium for the pursuit of health information. OBJECTIVES The previous analysis spanned 42 years of literature; this article describes an analysis of the last 10 years of literature on HISB and how online seeking has caused the concept to evolve in the literature. METHODS This study used the concept analysis methodology employed by Lambert and Loiselle in the original analysis. It also included a systematic search conducted in five databases to identify studies from 2007 to 2017, using similar inclusion criteria from the original study. RESULTS Of the more than 500 articles retrieved, 85 journal articles met the inclusion criteria. Consistent with the original work, articles that included outcomes were identified as either behavioural or cognitive. CONCLUSION Most of the attention of the works studied focused on individuals and their information source preferences. This HISB analysis can be incorporated with studies to understand how various communities seek information in online versus non-online contexts.
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Affiliation(s)
- Margaret S Zimmerman
- School of Library and Information Science, University of Iowa, Iowa City, IA, USA
| | - George Shaw
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA
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17
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Rampamba EM, Meyer JC, Helberg EA, Godman B. Empowering Hypertensive Patients in South Africa to Improve Their Disease Management: A Pharmacist-Led Intervention. J Res Pharm Pract 2019; 8:208-213. [PMID: 31956634 PMCID: PMC6952763 DOI: 10.4103/jrpp.jrpp_18_74] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 01/13/2019] [Indexed: 11/23/2022] Open
Abstract
Objective: Uncontrolled hypertension negatively impacts on mortality. This study aimed to evaluate the impact of a pharmacist-led patient counseling and education model to empower hypertensive patients on chronic medication. Methods: This was an operational research project with a quasi-experimental design including an intervention group (55 patients) and a control group (31 patients) of chronic hypertensive patients. The data were collected with interview-administered questionnaires, and were analyzed using SAS® version 9.4. Pharmacist interventions included an educational diary on hypertension management and patient counseling. Findings: A 34.7% improvement was observed in patients’ understanding of what normal blood pressure (BP) is in the intervention group compared to the control group (P < 0.001), whereas a 9.1% improvement was also observed in the intervention group in their knowledge about the fact that systolic BP and diastolic BP are both important in controlling hypertension, with no change in the control group. After the intervention, 40.0% of patients in the intervention group versus 17.9% in the control group had adequate knowledge (≥75% correct answers) about hypertension and its management. Pharmacist interventions were well received by the majority of patients (>90%). Conclusion: A pharmacist-led patient counseling and education model can help improve patients’ hypertension knowledge and BP control. These should increasingly become routine, aiming to improve chronic disease management.
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Affiliation(s)
- Enos M Rampamba
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa
| | - Johanna C Meyer
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa
| | - Elvera A Helberg
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa
| | - Brian Godman
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, South Africa.,Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow G4 ORE, UK.,Health Economics Centre, Management School, Liverpool University, Liverpool, UK.,Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital, Huddinge, Stockholm, Sweden
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18
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Mlyuka H, Salehe H, Mikomangwa W, Kilonzi M, Marealle A, Mutagonda R, Bwire GM. Level of medication self-management capacity among patients on ambulatory care exiting hospital pharmacy at Muhimbili National Hospital, Tanzania: a descriptive cross-sectional study. BMC Res Notes 2019; 12:731. [PMID: 31699132 PMCID: PMC6839124 DOI: 10.1186/s13104-019-4772-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/30/2019] [Indexed: 01/13/2023] Open
Abstract
Objectives Medication management capacity of a patient on ambulatory care is direct related to adherence. To our knowledge data on medication management capacity for ambulatory care patients exiting outpatient pharmacy outlets in Tanzania are scarce. This study aimed to determine the level of medication management capacity among patients on ambulatory care exiting Muhimbili National Hospital outpatient pharmacy outlet. Results A total of 424 patients on ambulatory care participated in the study. Three hundred eighty-seven (91.3%) out of 424 interview questionnaires had complete data and qualified for data analysis. Majority (62.3%) out of 387 study participants had poor medication management capacity; 65.3% out of 387 patients were unable to correctly read the prescription and match the drugs they are carrying. More than half (57.4%) out of 387 participants were unable to correctly take the dose, 73.9% out of 387 were unable to correctly tell the dosing frequency and duration. Only 10.6% out 155 patients with prescription containing drugs with warning or precaution or contraindication or potential side effects were aware.
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Affiliation(s)
- Hamu Mlyuka
- Clinical Pharmacy and Pharmacology Department, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania.
| | - Hija Salehe
- Clinical Pharmacy and Pharmacology Department, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania
| | - Wigilya Mikomangwa
- Clinical Pharmacy and Pharmacology Department, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania
| | - Manase Kilonzi
- Clinical Pharmacy and Pharmacology Department, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania
| | - Alphonce Marealle
- Clinical Pharmacy and Pharmacology Department, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania
| | - Ritah Mutagonda
- Clinical Pharmacy and Pharmacology Department, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania
| | - George M Bwire
- Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania
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19
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Opare-Addo MN, Buabeng KO, Marfo AF, Osei FA, Owusu-Dabo E, Ansong D, Anto BP, Boaheng JM, Nyanor I. Source of medicines and medicine information by self-reported persons living with hypertension and diabetes in rural and urban Ghana. Pharm Pract (Granada) 2018; 16:1151. [PMID: 30416620 PMCID: PMC6207351 DOI: 10.18549/pharmpract.2018.03.1151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 08/14/2018] [Indexed: 11/16/2022] Open
Abstract
Objectives: This study was conducted to determine the source of medicines and medicine information of persons living with hypertension and diabetes in rural and urban Ghana and assessing if they are influenced by predisposing and enabling factors as defined by Andersen’s behavioural model. Methods: A population based cross sectional study was conducted in four (4) rural and four (4) urban districts in the Ashanti Region of Ghana. A multistage and proportional sampling method was used in enrolling participants aged 18 years and above. A pre-tested structured questionnaire was used to collect primary data from respondents. Data collected was exported to STATA for analysis. Descriptive analysis was performed. Chi-square tests/Fisher’s exact test and multinomial logistic regression models were used to establish association between variables. Results: A total of 336 self -reported persons with hypertension and diabetes were enrolled in the study with 199(59.23%) living in urban communities. The majority of participants with hypertension and diabetes living in the rural communities 77 (56.20%) were females contrasting with the male majority in urban communities 106 (53. 27%). In the rural communities, 49 (35.77%) of participants sourced medicines from the health centre while 45 (32.85%) and 35(25.55%) sourced medicines from the hospital and over the counter medicine shop (OTCMS) respectively. In the urban communities, 153 (76.88%) sourced medicines from the hospital while 33 (16.58%) sourced medicines from the pharmacy. The predisposing factor age (OR: 1.1, 95%CI 1.040-1.210) under OTCMS, age (OR 1.0, 95% CI: 1.002-1.066) under hospital and enabling factor socioeconomic status (OR: 0.3, 95%CI 0.085-0.855) under Hospital influenced participant’s source of medicine in the urban communities. The results also revealed that majority of participants in both rural 99 (72.26%), and urban 164 (82.41%) communities sourced medicine information mainly from public healthcare facilities, pre-disposing factors; age (OR 1.1 95%CI 1.032-1.270) under family member, age (OR 1.1, 95%CI 1.022-1.167) under friend health professional, age (OR 1.1, 95%CI 1.050-1.147) under nearest health institution, marital status (OR: 0.004, 95%CI 0.003-0.441) under friend health Professional were found to influence participants’ source of medicine information in the urban communities while in the rural communities the predisposing factor marital status (OR 10.6, 95%CI 1.044 -106.835), education (OR: 26.1, 95%CI 1.271-537.279) under friend health professional, age (OR 1.1, 95%CI 1.002-1.187), educational level (OR 30.6, 95%CI 1.718-546.668) under nearest health institution and enabling factor socio-economic status (OR 6.6, 95%CI 1.016 -43.510) under nearest health institution influenced one’s source of medicine information. Conclusions: Majority of inhabitants with hypertension and diabetes in both rural and urban communities, sourced medicines and medicine information from public health institutions though a larger proportion was recorded in the urban communities. More participants in the rural communities than in the urban communities sourced medicines and medicine information from community pharmacies. Participants’ source of medicine and medicine information was influenced by both predisposing and enabling factors.
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Affiliation(s)
- Mercy N Opare-Addo
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology. Kumasi (Ghana).
| | - Kwame O Buabeng
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceu-tical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology. Kumasi (Ghana).
| | - Afia F Marfo
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology. Kumasi (Ghana).
| | - Francis A Osei
- Kumasi Centre for Collaborative Research in Tropical Medicine. Kumasi, (Ghana).
| | - Ellis Owusu-Dabo
- Kumasi Centre for Collaborative Research in Tropical Medicine. School of Public Health, College of Health Sciences Kwame Nkrumah University of Science and Technology, Kumasi (Ghana)
| | - Daniel Ansong
- School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology. Kumasi (Ghana).
| | - Berko P Anto
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology. Kumasi (Ghana).
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Rampamba EM, Meyer JC, Godman B, Kurdi A, Helberg E. Evaluation of antihypertensive adherence and its determinants at primary healthcare facilities in rural South Africa. J Comp Eff Res 2018; 7:661-672. [DOI: 10.2217/cer-2018-0004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aim: To evaluate adherence to antihypertensive treatment in rural South Africa and identify potential determinants given concerns with adherence and its impact in this priority disease area. Patients & methods: Face-to-face interviews with hypertensive patients and rating their adherence to treatment using defined categorized responses. Associations between adherence and patient characteristics assessed and sensitivity analyses performed. Results: 54.6% of patients were adherent to treatment. Controlled blood pressure (BP; odds ratios [OR] = 2.1; 95% CI: 1.1, 3.8; p = 0.019), comorbidity (OR = 2.0; 95% CI: 1.1, 3.6; p = 0.032) and smoking (OR = 0.3; 95% CI: 0.1, 0.8; p = 0.018) were associated with adherence. Conclusion: Adherence and BP control were suboptimal, only smoking was an independent risk factor for adherence. Adherent patients were twice as likely to have controlled BP, although results were sensitive to the definition of adherence. Initiatives are in place to improve adherence, which will be monitored.
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Affiliation(s)
- Enos M Rampamba
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa
- Department of Health, Tshilidzini Hospital, Limpopo Province, South Africa
| | - Johanna C Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, UK
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Health Economics Centre, Liverpool University Management School, Liverpool, UK
| | - Amanj Kurdi
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Elvera Helberg
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa
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21
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Stonbraker S, Smaldone A, Luft H, Cushman LF, Lerebours Nadal L, Halpern M, Larson E. Associations between health literacy, HIV-related knowledge, and information behavior among persons living with HIV in the Dominican Republic. Public Health Nurs 2017; 35:166-175. [PMID: 29285785 DOI: 10.1111/phn.12382] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the health literacy levels of persons living with human immunodeficiency virus (HIV) (PLWH) at a health clinic in the Dominican Republic (DR) and assess associations between health literacy, HIV-related knowledge, and health information behavior (how patients need, seek, receive, and use information). DESIGN AND SAMPLE Cross-sectional, descriptive. Participants were 107 PLWH attending the Clinic. MEASURES A theoretically based, 64-item survey assessing information behavior and HIV-related knowledge was administered in Spanish through individual interviews. Health literacy was assessed using the Short Assessment of Health Literacy-Spanish and English. RESULTS On average, participants were 40.8 years old and had lived with HIV for 7.7 years. The majority (69.2%) had low health literacy. HIV-related knowledge and information behavior varied by health literacy level and uncertainty regarding a main indicator of disease progression, viral load, was demonstrated regardless of health literacy level. Participants with low health literacy were less likely to answer questions or answer questions correctly and many participants (39.2%) indicated viral transmission can occur through supernatural means. CONCLUSIONS Findings demonstrate unmet information need and that information received may not always be understood. Methods to improve health education are needed to ensure patients receive health information in an understandable way.
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Affiliation(s)
- Samantha Stonbraker
- Columbia University School of Nursing, New York, NY, USA.,Clínica de Familia, La Romana, Dominican Republic
| | - Arlene Smaldone
- Columbia University School of Nursing, New York, NY, USA.,Columbia University College of Dental Medicine, New York, NY, USA
| | - Heidi Luft
- Columbia University School of Nursing, New York, NY, USA
| | - Linda F Cushman
- Department of Population and Family Health, Mailman School of Public Health, New York, NY, USA
| | | | - Mina Halpern
- Clínica de Familia, La Romana, Dominican Republic
| | - Elaine Larson
- Columbia University School of Nursing, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
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22
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Marimwe C, Dowse R. Development of an item bank of health literacy questions appropriate for limited literacy public sector patients in South Africa. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17538068.2017.1380577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chipiwa Marimwe
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Ros Dowse
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
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Abstract
Supplemental Digital Content is Available in the Text. Background: As test and treat rolls out, effective interventions are needed to address the determinants of outcomes across the HIV treatment continuum and ensure that people infected with HIV are promptly tested, initiate treatment early, adhere to treatment, and are virally suppressed. Communication approaches offer viable options for promoting relevant behaviors across the continuum. Conceptual Framework: This article introduces a conceptual framework, which can guide the development of effective health communication interventions and activities that aim to impact behaviors across the HIV treatment continuum in low- and medium-income countries. The framework includes HIV testing and counseling, linkage to care, retention in pre-antiretroviral therapy and antiretroviral therapy initiation in one single-stage linkage to care and treatment, and adherence for viral suppression. The determinants of behaviors vary across the continuum and include both facilitators and barriers with communication interventions designed to focus on specific determinants presented in the model. At each stage, relevant determinants occur at the various levels of the social–ecological model: intrapersonal, interpersonal, health services, community, and policy. Effective health communication interventions have mainly relied on mHealth, interpersonal communication through service providers and peers, community support groups, and treatment supporters. Discussion: The conceptual framework and evidence presented highlight areas across the continuum where health communication can significantly impact treatment outcomes to reach the 90-90-90 goals by strategically addressing key behavioral determinants. As test and treat rolls out, multifaceted health communication approaches will be critical.
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Rampamba EM, Meyer JC, Helberg E, Godman B. Knowledge of hypertension and its management among hypertensive patients on chronic medicines at primary health care public sector facilities in South Africa; findings and implications. Expert Rev Cardiovasc Ther 2017; 15:639-647. [PMID: 28712328 DOI: 10.1080/14779072.2017.1356228] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND There are high growing prevalence rates of hypertension in South Africa. Consequently, there is a need to assess knowledge and management among hypertensive patients receiving chronic medication from primary health care (PHC) facilities in South Africa as a basis for improving future management. This is important as South Africa seeks to improve its management of chronic diseases. METHODS Descriptive, quantitative study amongst chronic hypertensive patients in the chronic disease programme. Patients were interviewed face-to-face by trained pharmacists using a structured questionnaire. Data analysis included descriptive and inferential statistics. RESULTS Half (53.7%) of the patients had uncontrolled blood pressure (BP). Less than a third of patients (27.7%) knew what hypertension is, the meaning of recorded BP numbers (4.5%), and what normal BP should be (19.9%). All patients who knew the meaning of BP numbers had formal education (p = 0.047). Only 15.6% of the 56.0% patients, who received hypertension information, received it on antihypertensive medicines specifically. CONCLUSIONS The majority of the patients lacked hypertension specific knowledge and only half had controlled BP. Interventions to improve the control of high BP should be targeted at closing knowledge gaps as part of the current chronic treatment initiatives in South Africa to ensure the benefits of increased access to care are realized.
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Affiliation(s)
- Enos M Rampamba
- a School of Pharmacy , Sefako Makgatho Health Sciences University , Pretoria , South Africa
| | - Johanna C Meyer
- a School of Pharmacy , Sefako Makgatho Health Sciences University , Pretoria , South Africa
| | - Elvera Helberg
- a School of Pharmacy , Sefako Makgatho Health Sciences University , Pretoria , South Africa
| | - Brian Godman
- b Division of Clinical Pharmacology , Karolinska Institute , Stockholm , Sweden.,c Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , United Kingdom.,d Health Economics Centre , Liverpool University Management School , Liverpool , United Kingdom
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25
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Stonbraker S, Larson E. Health-information needs of HIV-positive adults in Latin America and the Caribbean: an integrative review of the literature. AIDS Care 2016; 28:1223-9. [PMID: 27098484 DOI: 10.1080/09540121.2016.1173645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
An assessment of information needs is essential for care planning for patients living with chronic diseases such as human immunodeficiency virus (HIV). The extent to which these assessments have been conducted in Latin America and the Caribbean (LAC) is unknown. The purpose of this study was, therefore, to identify, evaluate, and summarize what research has been conducted to examine patient perceptions of their health-information needs among adults living with HIV in LAC. Using an integrative review methodology, a literature search of six databases was conducted in April and May 2015. Inclusion criteria were peer-reviewed articles published in English or Spanish that assessed the information needs of HIV-positive patients living in LAC. The quality of included articles was assessed and relevant characteristics of each article were extracted, compared, and presented. Searches returned 1885 citations, 11 of which met inclusion criteria. Studies included were conducted in 8 of 33 countries, used multiple research designs, demonstrated varying needs between populations, and found numerous unmet information needs. Information about HIV in general, methods of infection transmission, antiretroviral medications, other sexually transmitted diseases, and effective coping mechanisms were the most commonly mentioned needs. Healthcare providers were the largest and most reliable source of health information for many participants and it was emphasized that in order for health education to be effective, programs should include both individual and group components. Patients indicated that they may have difficulty processing and using information through an incorrect understanding of medications, not changing risk behaviors, and by stating that information can be overwhelming or poorly communicated. Further research on information needs is warranted so that healthcare providers and organizations may provide the information patients need to appropriately manage their health.
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Affiliation(s)
| | - Elaine Larson
- a Columbia University School of Nursing , New York , NY , USA.,b Department of Epidemiology , Mailman School of Public Health , New York , NY , USA
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Mbuagbaw L, Bonono Momnougui RC, Thabane L, Ongolo-Zogo P. The health competence measurement tool (HCMT): developing a new scale to measure self-rated "health competence". PATIENT EDUCATION AND COUNSELING 2014; 97:396-402. [PMID: 25308953 DOI: 10.1016/j.pec.2014.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 09/16/2014] [Accepted: 09/22/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To develop and test a tool for measuring health competence. METHODS In order to measure this attribute, we used a sequential exploratory mixed methods design in rural and urban communities in Cameroon. In the qualitative phase, 67 clients constituted 10 focus groups to elicit themes related to health competence. In the quantitative phase, self-rated items were tested on 300 participants and on a random selection of 25 participants 2 weeks later. RESULTS The internal consistency for the subscales derived varied from 0.61-0.81. Older (F[45, 339.1]=1.2; p=0.031) and more educated (F[3, 22.6]=2.1; p=0.004) people were more likely to score higher on the scale. Interviewers also contributed to the variance (F[5, 37.6]=3.6; p<0.001). Test-retest reliability was 0.66. The final scale with 15 items is made up of three subscales: knowledge of disease, how to stay in good health and health information. CONCLUSION We present a new self-rated scale for health competence with good psychometric properties. It circumvents the need to be literate, but requires well trained interviewers. We recommend that it be tested in other settings. PRACTICE IMPLICATIONS This tool should be used to appraise individual and community health education needs with minor context specific modifications.
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Affiliation(s)
- Lawrence Mbuagbaw
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare - Hamilton, ON, Canada; Centre for the Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon.
| | | | - Lehana Thabane
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare - Hamilton, ON, Canada; Departments of Paediatrics and Anaesthesia, McMaster University, Hamilton, ON, Canada; Centre for Evaluation of Medicines, St Joseph's Healthcare - Hamilton, ON, Canada; Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada.
| | - Pierre Ongolo-Zogo
- Centre for the Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
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