Educating Pharmacists on the Risks of Strong Opioids With Descriptive and Simulated Experience Risk Formats: A Randomized Controlled Trial.
Educating Pharmacists on the Risks of Strong Opioids With Descriptive and Simulated Experience Risk Formats: A Randomized Controlled Trial.
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DOI：
10.1177/23814683211042832
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发表时间：
2021-07
影响因子：
--
通讯作者：
Hertwig R
中科院分区：
文献类型：
--
作者：
Wegwarth O;Wind S;Goebel E;Spies C;Meerpohl JJ;Schmucker C;Schulte E;Neugebauer E;Hertwig R
目标.美国和欧洲的高阿片类药物处方率表明，那些开处方，分发和服用阿片类药物的人存在错误的风险认知。认知决策科学的研究结果表明，风险认知和行为可能会有所不同，这取决于人们是通过经验还是描述来了解风险。本研究调查了描述性与经验为基础的风险教育形式对药剂师的风险认知和咨询行为的影响，长期管理强阿片类药物慢性非癌症疼痛患者。方法.在一项探索性的随机对照在线试验中，300名德国药剂师被随机分配到描述性格式（事实框）或模拟经验格式（交互式模拟）。主要结果指标。1)客观风险知觉，2）主观风险知觉，3）预期和4）实际咨询行为。结果这两种风险格式显着提高药剂师的客观风险感知，但药剂师暴露于事实框估计的利益-危害比比更准确地比暴露于模拟。这两种格式证明同样有效地调整药剂师的主观风险感知，以更好地认识阿片类药物的危害;然而，药剂师接受模拟显示出更大的变化，他们的实际咨询行为和更高的一致性之间的预期和实际咨询比药剂师接受事实框。结论模拟经验格式在提高药剂师的客观风险认知方面不如描述性格式有效，在激励药剂师为患者提供风险较小的治疗方案方面同样有效，在改变报告的实际咨询行为方面更有效。影响。这些探索性的研究结果提供了重要的见解，预防经验的差距，药物安全性的相关性，并提出了未来的研究有关的具体机制在工作中的问题。
Objectives. High opioid prescription rates in the United States and Europe suggest miscalibrated risk perceptions among those who prescribe, dispense, and take opioids. Findings from cognitive decision science suggest that risk perceptions and behaviors can differ depending on whether people learn about risks by experience or description. This study investigated effects of a descriptive versus an experience-based risk education format on pharmacists’ risk perceptions and counseling behavior in the long-term administration of strong opioids to patients with chronic noncancer pain. Methods. In an exploratory, randomized controlled online trial, 300 German pharmacists were randomly assigned to either a descriptive format (fact box) or a simulated experience format (interactive simulation). Primary Outcome Measures. 1) Objective risk perception, 2) subjective risk perception, and 3) intended and 4) actual counseling behavior. Results. Both risk formats significantly improved pharmacists’ objective risk perception, but pharmacists exposed to the fact box estimated the benefit-harm ratio more accurately than those exposed to the simulation. Both formats proved equally effective in adjusting pharmacists’ subjective risk perception toward a better recognition of opioids’ harms; however, pharmacists receiving the simulation showed a greater change in their actual counseling behavior and higher consistency between their intended and actual counseling than pharmacists receiving the fact box. Conclusion. The simulated experience format was less effective than the descriptive format in improving pharmacists’ objective risk perception, equally effective in motivating pharmacists to counsel patients on less risky treatment alternatives and more effective in changing the reported actual counseling behavior. Implications. These exploratory findings provide important insights into the relevance of the description-experience gap for drug safety and raise questions for future research regarding the specific mechanisms at work.
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影响因子：
4.1
作者：
Hogarth, Robin M.;Soyer, Emre
通讯作者：
Soyer, Emre
影响因子：
50
作者：
Kalkman, Gerard Arnoldus;Kramers, Cornelis;Schellekens, Arnt
通讯作者：
Schellekens, Arnt
影响因子：
3.6
作者：
Caverly, Tanner J.;Prochazka, Allan V.;Matlock, Daniel D.
通讯作者：
Matlock, Daniel D.
影响因子：
3.6
作者：
Armstrong, Bonnie;Spaniol, Julia
通讯作者：
Spaniol, Julia
影响因子：
158.5
作者：
CASSCELLS, W;SCHOENBERGER, A;GRABOYS, TB
通讯作者：
GRABOYS, TB