PHARMACEUTICAL CARE OUTCOMES--THE PATIENT ROLE

患者在药物治疗中的作用是重要的， 在药学服务研究中被忽视的干预变量， 健康成果。 然而，患者在处方方面的决定 和非处方药（OTC）可以有深远的健康后果， 发病率和卫生保健利用率。 本研究 建议从病人的角度来检查这个过程， 关节炎患者的药物治疗方案决定的结果。 三个主要 研究问题将被审查：1）如何病人的看法 关于生活质量、症状和药物益处的影响：a） 药物方案依从性（处方或推荐）和B）OTC自我护理 使用; 2）患者用药行为（依从性）的影响 和OTC自我护理使用）对关节炎结局的影响，包括生活质量， 临床症状和卫生保健利用; 3）患者如何 对生活质量的看法因临床症状而异？ 关节炎患者将从2个风湿病门诊入组 门诊随访3年。 样本将包括450个 类风湿性关节炎（RA）患者和300例骨关节炎（OA）患者 患者 每六个月将对个人进行一次电话采访。 RA患者每3个月进行一次临床访视， 6个月的OA患者依从性、OTC自我护理、信念 关于他们的药物治疗，身体体验，生活质量，以及 自掏腰包的药物费用。 将使用客户日历日记 协助收集关于副作用、健康 服务利用（住院、急诊室使用）、购买 非处方药 每年收集药房患者档案记录 来验证病人的服药依从性报告 临床措施 个人的疾病和症状将通过实验室收集 和物理测量。 他们的药物治疗 将分析行为和健康相关结果。 的分析 由于疾病的差异，OA和RA将单独进行 随着时间的推移，疾病进展、药物治疗方案和功能状态。 的 一般的分析计划是测试来自三个假设 研究问题。 将生成以下内容的描述性统计量：1） 2）AIMS量表评分; 3)疾病活动性水平测量; 4）功能分类; 5)OTC自我护理;和6）协变量假设是重要的， 药物依从性和关节炎结果。 连续依赖 将使用多元回归模型分析变量 技术. 将分析二元和有序因变量 使用多元逻辑回归。

The patient's role in drug therapy is an important and largely overlooked intervening variable in the study of pharmaceutical care and health outcomes. Yet patient decisions with respect to prescription and over-the-counter (OTC) drugs can have profound health outcomes in terms of morbidity and health care utilization. In this study, we propose to examine from a patient's perspective the process and outcomes of arthritis patients' drug regimen decisions. Three primary research questions will be examined: 1) how do patient perceptions about quality of life, symptoms, and medication benefits affect: a) drug regimen adherence (prescribed or recommended) and b) OTC self-care use; 2) what are the effects of patient medication behaviors (adherence and OTC self-care use) on arthritis outcomes including quality of life, clinical symptoms, and health care utilization; 3) how do a patient's perceptions of quality of life vary with their clinical symptoms? Arthritis patients will be enrolled from 2 rheumatology outpatient clinics and followed for 3 years. The sample will include 450 rheumatoid arthritis (RA) patients and 300 osteoarthritis (OA) patients. Individuals will be interviewed by telephone every six months and at clinic visits every 3 months for RA patients and every 6 months for OA patients about their adherence, OTC self-care, beliefs about their medications, somatic experience, quality of life, and out- of-pocket costs of medications. Client calendar diaries will be used to assist interview data collection regarding side effects, health service utilization (hospitalization, emergency room use), purchase of OTC drugs. Pharmacy patient profile records will be collected annually to validate patient reports of medication adherence. Clinical measures of the individual's disease and symptoms will be gathered through Lab and physical measurements. The relationship between their medication behaviors and health related outcomes will be analyzed. Analyses for OA and RA will be done separately because of the differences in disease progression, medication regimen, and functional status over time. The general analysis plan is to test hypotheses derived from the three research questions. Descriptive statistics will be generated for: 1) patterns of adherence to recommended regimens; 2) AIMS scale scores; 3) level of disease activity measures; 4) functional classification; 5) OTC self care; and 6) covariates hypothesized to be important to medication adherence and arthritis outcomes. Continuous dependent variables will be analyzed using multiple regression modelling techniques. Binary and ordinal dependent variables will be analyzed using multiple logistic regression.