PHARMACEUTICAL CARE OUTCOMES--THE PATIENT ROLE

患者在药物治疗中的作用是重要的，在很大程度上 药学护理研究中被忽视的干预变量 健康结果。然而，患者对处方的决定 而非处方药(OTC)可以在以下方面产生深远的健康后果 关于发病率和卫生保健利用的条款。在这项研究中，我们 建议从病人的角度检查这一过程和 关节炎患者用药方案决定的结果。三个主要因素 研究问题将被检查：1)患者如何感知 关于生活质量、症状和药物福利影响：a) 服药依从性(处方或推荐)和b)非处方药自我护理 使用；2)患者的用药行为(依从性)有什么影响 和非处方药自我护理使用)对关节炎结果的影响，包括生活质量， 临床症状和卫生保健利用情况；3)患者如何 对生活质量的看法随着他们的临床症状而不同？ 关节炎患者将从2名风湿病门诊患者中登记 临床观察并随访3年。样本将包括450个 类风湿关节炎(RA)患者和300例骨关节炎(OA)患者 病人。个人将每六个月接受一次电话采访 3个月和每3个月一次的RA患者和 为OA患者提供6个月的时间，了解他们的依从性、非处方药自我护理、信念 关于他们的药物，身体体验，生活质量，以及- 药物的自付费用。将使用客户端日历日记 协助收集有关副作用、健康的访谈数据 服务利用(住院、急诊室使用)、购买 非处方药。药房将每年收集患者档案记录 以验证患者的服药依从性报告。临床措施 个人的疾病和症状将通过实验室收集 和体格测量。他们的用药之间的关系 将分析与行为和健康相关的结果。对以下项目的分析 由于疾病的差异，骨关节炎和类风湿关节炎将分开进行 随着时间的推移，进展、用药方案和功能状态。这个 一般的分析计划是检验从这三个方面得出的假设 研究问题。将为以下项生成描述性统计数据：1) 坚持推荐方案的模式；2)AIMS量表得分； 3)疾病活动性指标水平：4)功能分类； 5)非处方药自我护理；6)假设重要的协变量 服药依从性和关节炎结果。连续相依 变量将使用多元回归模型进行分析 技巧。将分析二进制和序数因变量 采用多元Logistic回归分析。

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.