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- De Smedt, Ruth H E, et al.
(författare)
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Perceived Adverse Drug Events in Heart Failure Patients Perception and Related Factors
- 2011
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Ingår i: JOURNAL OF CARDIOVASCULAR NURSING. - : Aspen Publishers Inc. - 0889-4655. ; 26:3, s. 250-260
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with heart failure (HF) often perceive adverse drug events (ADEs), affecting quality of life. For weighing the benefits and burden of medication in HF care, knowledge on patients perception of ADEs is needed. Our aim was to assess these ADE perceptions and to identify factors related to these perceptions. Methods: A cross-sectional study was performed including HF patients recruited from primary care and outpatient clinics. Patients were included in the analysis if they perceived an ADE in the past 4 weeks. This information was collected using an open-ended question and a symptom checklist. Data on ADE perception were obtained using a modified version of the Revised Illness Perception Questionnaire. Demographic, clinical, and ADE characteristics were collected by self-administered questionnaire and chart review. The relations between these factors and ADE perceptions were analyzed using regression analyses. Results: In total, 261 HF patients perceived an ADE and completed the questionnaire. Patients reported 814 ADEs, of which 26% of the patients reported dizziness and 24% reported dry mouth as being the most prevalent. Almost half of the patients (46%) perceived their ADE as something serious, with major consequences for their daily life (40%) and reported to be worried (36%) about the ADE. Patients perceived the ADE as a chronic problem (91%), and the majority believed more in the ability of the health care provider to control the ADE (61%) than in their own ability (46%). Demographic and clinical variables had a limited contribution to the explained variance of ADE perceptions after adjusting for ADE characteristics, such as perceived severity. Conclusion: Patients with HF perceive particular negative consequences and emotional distress of symptomatic ADE. Open communication between patients and providers with attention for patients ADE perceptions would be valuable during the decision process of ADE management and may result in a regimen aligned with patients preferences and needs.
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- De Smedt, Ruth H E, et al.
(författare)
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Self-reported adverse drug events and the role of illness perception and medication beliefs in ambulatory heart failure patients : A cross-sectional survey
- 2011
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 48:12, s. 1540-1550
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Tidskriftsartikel (refereegranskat)abstract
- Background: Identifying patients with heart failure (HF) who are at risk of experiencing symptomatic adverse drug events (ADEs) is important for improving patient care and quality of life. Several demographic and clinical variables have been identified as potential risk factors for ADEs but limited knowledge is available on the impact of HF patients beliefs and perceptions on their experience of ADEs. less thanbrgreater than less thanbrgreater thanObjective: The purpose of the study was to identify the relationship between HF patients illness perception and medication beliefs and self-reported ADEs. less thanbrgreater than less thanbrgreater thanDesign: A cross-sectional survey was performed between November 2008 and March 2009. less thanbrgreater than less thanbrgreater thanSettings: One university medical centre, two regional hospitals and 20 general practitioners in the Netherlands participated in the study. less thanbrgreater than less thanbrgreater thanParticipants: 495 patients with HF were included. less thanbrgreater than less thanbrgreater thanMethods: Patients completed the validated Revised Illness Perception Questionnaire (IPQR) and the Beliefs about Medication Questionnaire (BMQ) which collected data on their illness perception and medication beliefs. In addition, data on ADEs as experienced in the previous four weeks were collected through an open-ended question and a symptom checklist. Multivariate logistic regression was performed to identify factors associated with these ADEs. less thanbrgreater than less thanbrgreater thanResults: In total, 332 (67%) patients had experienced ADEs in the previous four weeks, of whom 28% reported dry mouth, 27% dizziness and 19% itchiness as the most prevalent. In the adjusted multivariate analysis, disease-related symptoms (illness identity) (OR for 1-5 symptoms 3.57: 95% CI 2.22-5.75, OR for andgt;5 symptoms 7.37; 95% CI 3.44-15.8), and general beliefs about medication overuse (OR 1.07; 95% CI 1.01-1.13) were independently associated with experiencing ADEs, whereas none of the demographic or clinical factors were significant. less thanbrgreater than less thanbrgreater thanConclusions: HF patients who perceive a high number of disease symptoms and have negative medication beliefs are at higher risk of experiencing self-reported ADEs. We suggest that future studies and interventions to improve ADE management should focus on negative medication beliefs and assisting patients in differentiating disease symptoms from ADEs. (C) 2011 Published by Elsevier Ltd.
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- De Smedt, Ruth H E, et al.
(författare)
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The impact of perceived adverse effects on medication changes in heart failure patients.
- 2010
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Ingår i: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164 .- 1532-8414. ; 16:2, s. 135-41.e2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Given the importance of patient safety and well-being, we quantified the likelihood and type of medication changes observed after 5 possible adverse effects (AE) perceived by heart failure (HF) patients. METHODS AND RESULTS: We conducted a retrospective cohort study using 18 months follow-up data from the Coordinating study evaluating Outcomes of Advising and Counseling in HF study on 754 patients previously hospitalized for HF (NYHA II-IV, mean age 70 years). Data used for this secondary analysis included problem checklists that patients had completed at 3 points in time, and medication data collected from chart review. Changes in potential causal cardiovascular medication and relevant alleviating medication were classified. Within group and relative risks (RR) for medication changes were calculated. Of the 754 patients, 50% reported dizziness, 44% dry cough, 19% nausea, 19% diarrhea, and 12% gout on the first checklist. Overall, the likelihood of a medication change was increased by 38% after a perceived AE. Dry cough had the highest increased likelihood of an associated cardiovascular medication change (RR 1.83, CI 1.35-2.49). Patients reporting gout had a four fold higher likelihood of alleviating medication started or intensified. CONCLUSIONS: A considerable number of HF patients perceived possible AE. However, the likelihood of medication being changed after a possible AE was rather low. There seems to be room for improving the management of AE.
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