Effects of Literacy on Medication Safety In the Elderly

描述（由申请人提供）：老年人占美国处方药消费量的1/3，并且发生用药错误（ME）和药物不良事件（ADE）的风险更大。他们也更有可能有低健康素养，增加了与药物有关的问题的可能性。ME和ADE的数据主要在医院收集，在那里更容易监测此类错误并识别遇到药物相关问题的患者。这种方法在美国并不是最佳的，因为这里的大多数药物都是由初级保健医生在门诊开的。拟议的研究将描述老年人的ME和ADE谱，以及健康素养如何影响用药安全。本申请的目的是确定功能性健康素养（FHL）较低（不足和边缘）的老年初级保健患者与具有足够FHL的老年初级保健患者之间ME的频率、类型、严重程度和可预防性。此外，我们将进行认知访谈，以了解为什么可能会发生ME。这项研究将在一个初级保健研究网络，南方初级保健城市研究网络（SPUR-NetSM），这是位于得克萨斯州休斯顿。在本申请中，我们建议评估300名来自不同种族和社会经济背景的老年患者所使用的药物，这些患者由门诊诊所的初级保健提供者看到。这是一项独特的研究，因为我们的主要结局指标是ME，因为它发生在初级保健诊所;。此外，我们还将在不同种族、社会经济地位和文化程度的老年患者中产生研究结果，并比较ME和ADE的类型和发生率。本研究的结果将被用来设计干预措施，在初级保健诊所内实施和评估药物安全促进教育计划。拟议的研究是创新的，因为它将提供一个不同的初级保健人群中的ME和ADE的理解和健康素养与这些错误的关联。这项研究的结果将是重要的，因为数百万美国老年人将获得更好的护理质量。

DESCRIPTION (provided by applicant): The elderly account for 1/3rd of prescription drug consumption in the United States and are at greater risk for medication errors (MEs) and adverse drug events (ADEs). They are also more likely to have low health literacy that increases the possibility of medication-related problems. Data on MEs and ADEs are collected predominantly in hospitals where it is easier to monitor such errors and to identify patients experiencing medication-related problems. This approach is not optimal in the United States, because here most medications are prescribed in the outpatient setting by primary care physicians. The proposed study will describe the spectrum of MEs and ADEs in the elderly and how health literacy affects medication safety. The aim of this application is to determine the frequency, type, severity, and preventability of MEs among elderly primary care patients who have low (inadequate and marginal) functional health literacy (FHL) vs. elderly primary care patients who have adequate FHL. Furthermore, we will conduct cognitive interviews to understand why MEs may have occurred. The study will be conducted in a primary care research network, the Southern Primary care Urban Research Network (SPUR-NetSM), which is located in Houston, Texas. In this application, we propose to evaluate medications used by 300 elderly patients from diverse ethnic and socioeconomic backgrounds who are seen by primary care providers in outpatient clinics. This is a unique study, because our main outcome measure is ME as it occurs in primary care clinics;. Moreover, we will generate findings and compare types and rates of MEs and ADEs among elderly patients who have different ethnicity, socioeconomic status, and literacy. Findings from this study will be used to design interventions for medication-safety-promotion education programs to be implemented and evaluated within primary care clinics. The proposed research is innovative, because it will provide an understanding of MEs and ADEs in a diverse primary care population and the association of health literacy with such errors. The outcomes of the proposed research will be significant, because millions of the American elderly will receive improved quality of care.