Variability in Pharmacy Interpretations of Physician Prescriptions

被引：47

作者：

Wolf, Michael S. ^{[1
,2
]}

Shekelle, Paul ^{[6
]}

Choudhry, Niteesh K. ^{[3
,4
]}

Agnew-Blais, Jessica ^{[3
,4
]}

Parker, Ruth M. ^{[5
]}

Shrank, William H. ^{[3
,4
]}

机构：

[1] Northwestern Univ, Inst Healthcare Studies, Ctr Commun Healthcare, Hlth Literacy & Learning Program,Feinberg Sch Med, Chicago, IL 60611 USA

[2] Northwestern Univ, Feinberg Sch Med, Div Gen Internal Med, Chicago, IL 60611 USA

[3] Brigham & Womens Hosp, Div Pharmacoepidemiol & Pharmacoecon, Boston, MA 02115 USA

[4] Harvard Univ, Sch Med, Boston, MA USA

[5] Emory Univ, Sch Med, Atlanta, GA USA

[6] Greater Los Angeles Vet Affairs Healthcare Syst, Div Gen Internal Med, Los Angeles, CA USA

来源：

MEDICAL CARE | 2009年 / 47卷 / 03期

关键词：

pharmacy; physician; prescription; sig; instruction; medication; variability; health literacy; DRUG WARNING LABELS; LOW-LITERACY; MEDICATIONS;

D O I：

10.1097/MLR.0b013e31818af91a

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: The clarity of prescription drug instructions is a health literacy and medication safety concern. Objective: To assess the variability of pharmacy interpretations of physician prescriptions. Design: Identically written prescriptions for 4 common medications (atorvastatin, alendronate, trimethoprim/sulfamethoxazole, ibuprofen) were filled in 6 pharmacies (2 largest chains, 2 grocery stores, 2 independents) in 4 cities (Boston, Chicago, Los Angeles, Austin). Measurement: Components of the instruction were coded as dose, frequency, administration route, timing, indication, and auxiliary instructions. Results: In all, 85 labels were evaluated. Dose frequency was omitted on 6% of instructions ("take 1 tablet for cholesterol"). Timing was explicitly stated on 2% of instructions ("in the morning"). All prescriptions included indications; pharmacies transcribed these onto 38% of labels. The prescription for alendronate stated not to lie down for at least 30 minutes after taking; this was transcribed with 50% of instructions. Reading difficulty was above recommended levels for 46% of instructions; with 14% greater than a high school level. Conclusions: Efforts are needed to ensure patients receive clear, consistent information supporting safe medication use.

引用

页码：370 / 373

页数：4

共 18 条

[11]

SMITH M, 1997, LITERACY 21 CENTURY

[12]

STENNER AJ, 1988, LEXILE FRAMEWORK

[13] Physician communication when prescribing new medications [J].

Tarn, Derjung M. ;

Heritage, John ;

Paterniti, Debora A. ;

Hays, Ron D. ;

Kravitz, Richard L. ;

Wenger, Neil S. .

ARCHIVES OF INTERNAL MEDICINE, 2006, 166 (17) :1855-1862

[14]

THOMPSON J, 2003, PRACTICAL GUIDE COMT

[15]

WOLF M, 2007, PROMOTING HLTH LITER

[16] To err is human: Patient misinterpretations of prescription drug label instructions [J].

Wolf, Michael S. ;

Davis, Terry C. ;

Shrank, William ;

Rapp, David N. ;

Bass, Pat F. ;

Connor, Ulla M. ;

Clayman, Marla ;

Parker, Ruth M. .

PATIENT EDUCATION AND COUNSELING, 2007, 67 (03) :293-300

[17] Misunderstanding of prescription drug warning labels among patients with low literacy [J].

Wolf, Michael S. ;

Davis, Terry C. ;

Tilson, Hugh H. ;

Bass, Pat F., III ;

Parker, Ruth M. .

AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, 2006, 63 (11) :1048-1055

[18] A critical review of FDA-approved medication guides [J].

Wolf, Michael S. ;

Davis, Terry C. ;

Shrank, William H. ;

Neuberger, Marolee ;

Parker, Ruth M. .

PATIENT EDUCATION AND COUNSELING, 2006, 62 (03) :316-322

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