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Use of a HCV patients' education tool: the knowledge questionnaire with confidence degrees

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Introduction

Results and discussion

Conclusion

Methods

100% 80% 60% 50% NIA % IA % CA NCA 50% 60% 80% 100% 0 0 0 0 0 0 Patient 1 100 10 0 0 0 10 1 0 0 0 1 10 Patient 2 90 9 0 0 0 9 1 0 1 0 2 20 Patient 3 80 8 0 2 1 5 0 0 2 0 2 20 Patient 4 80 8 0 1 0 7 2 0 0 1 3 30 Patient 5 70 7 0 0 1 6 0 0 0 1 1 10 Patient 6 90 9 1 1 0 7 2 0 0 0 2 20 Patient 7 80 8 1 0 0 7 1 0 0 0 1 10 Patient 8 90 9 0 0 1 8 0 0 0 1 1 10 Patient 9 90 9 2 0 2 5 2 0 0 0 2 20 Patient 10 80 8 0 0 0 8 0 0 1 0 1 10 Patient 11 90 9 0 1 2 6 0 0 1 2 3 30 Patient 12 70 7 0 0 1 6 1 0 0 0 1 10 Patient 13 90 9 1 1 1 6

Incorrect answers Correct answers

Left Hemispectrum Right Hemispectrum

Table 1: Spectral distribution of patients’ answers at D15 or M1 Important number of serious misconceptions: these patients require an important process of unlearning (for items concerned) Patient 9: Several

answers with low certainty, a consolidation of

knowledge is necessary

Average rate of IA = 15,39 % Average rate of CA = 84,61 %

(IA) (CA)

Patient 12:

Percentage of correct answers is below the average,

a relearning is indicated

Patient 5: Percentage

of incorrect answers is above the average,

an educational intervention is recommended

Table 2: Spectral distribution of patients’ answers (%) at D15 or M1 and M3 or M6

100% 80% 60% 50% %IA %CA 50% 60% 80% 100% Answ ers at D15 or M1 7,69% 0% 3,85% 3,85% 15,39% Group of 13 patients 84,61% 3,85% 4,61% 6,92% 69,23% Answ ers at M3 or M6 0,77% 0% 0% 0,77% 1,54% Group of 13 patients 98,46% 0% 0% 0,77% 97,69%

Incorrect answ ers Correct answ ers

Left Hem ispectrum Right Hem ispectrum

Figure 1: Spectral distribution of all answers at D15 or M1 and at M3 or M6

2/ How to analyse the evolution of these 13 patients?

• Percentage of CA ↑ ; Average of certainties accompanying CA ↑ (93,91% to 99,84%)

A J-shaped spectral distribution of CA even more pronounced : ideal distribution (majority of CA with maximum certainty)

• Percentage of IA ↓ ; Average of certainties accompanying IA ↓ (77,49% to 75%)

• At D15 or M1 A discreet I-shaped spectral distribution of IA due to a significant number of errors with maximum certainty: castastrophic distribution

At M3 or M6 A flat distribution of IA explained by a very low rate of IA

Educational sequences ,adapted to the needs of each patient, have improved patients’ knowledge

1/ How to interpret the data of the spectral chart?

3/ Impact of educational sequences on patients’ compliance

9 3 1 12 1 0 0 5 10 15

Good compliance Minor noncompliance Non compliance

N um be r of pa ti ent

s

D15 or M1

M3 or M6

• Assessing this impact is difficult because of the good initialcompliance (at D15 or M1): « good compliance » for 9/13 patients

• However, an improved adherence has been observed

Figure 2: Patients’s compliance

The introduction of all Direct-Acting Antiviral (DAA) based therapy for chronic Hepatitis C Virus (HCV) has dramatically changed HCV treatment paradigms and promises HCV

cure in more than 95% of patients. In this context, educational sequences intended for patients with chronic hepatitis C have been implemented in our Hospital.

The objective of this study is to follow patient compliance and to assess the impact of these consultations on their knowledge and skills.

 The study was conducted in 5 steps:

Patients with chronic hepatitis C, treated by DAA since

January 2015, were prospectively included

Day 0: Patients were received individually by a pharmacist.

Information regarding treatment and disease were

given

Day 15 (D5) or Month 1 (M1): A knowledge questionnaire (True / False) with confidence

degrees, addressing the main themes of the infection was performed by a pharmacist

Educational sequences, adapted to the needs of each patient, were carried out using education tools like images and conceptual map.

Patients are seen by a pharmacist on a monthly basis

Month 3 (M3) or Month 6 (M6): The knowledge questionnaire was repeated at the end of the

treatment (M3 or M6).

 The knoweldge questionnaire with confidence degrees (for the method and processing of results see *):  10 questions; True/False; Confidence degrees: 50%, 60%, 80% or 100%

 Addressing the main themes of the infection: medications, mode of contamination…

 The pharmacist asks the questions in oral mode and records each answer a degree of certainty. He collects these degrees with the help of a spectral test

*

Leclercq D. La connaissance partielle chez le patient: pourquoi et comment la mesurer? Educ Ther Patient 2009; 1(2): S201-S2012

100 80 60 50 TRUE

I can associate my medication at any other medication purchased

in pharmacy FALSE 50 60 80 100

INCORRECT ANSWER (IA) (%) CORRECT ANSWER (CA) (%)

 Compliance evaluation test including 6 questions:

 Questionnaire established by X.Girerd  « Good compliance » when « No » was

answered to the 6 items; « minor compliance » when 1 or 2 « Yes » were given; « Noncompliance » when 3 or more « Yes » were given.

 The use of these confidence degrees is informative and can refine the measurement of knowledge. The simulations and self-assessments of patients, through questionnaires, facilitate

the establishment of cognitive and metacognitive diagnosis. This enables to consider educational interventions repeatedly adapted to the needs of each patient. The attempts to enhance

patients’ learning improve their self-care and psychosocial skills.

 Spectral analysis of the responses’ qualities is useful to measure patients’ degree of mastery as well as to evaluate the efficacity of an educational intervention applied to a

group of patients.

Perfect performance: CA with 100% • Partial knowledge: CA with 60% and 80% • Recognized ignorance: CA or IA with 50% • Recognized misconceptions: IA with 60% • Serious misconceptions: IA with 80% and 100%

Use of a HCV patients education tool: the knowledge questionnaire with confidence degrees

A. KERRAD

1

, D. LECLERCQ

2

, H. BARRETEAU

1

, H. TROUT

1

, D. LE GUINER

1

Figure

Table 1: Spectral distribution  of patients’ answers at  D15 or M1Important number of seriousmisconceptions: these patients require an important process of unlearning (for items concerned) Patient 9: Severalanswers with lowcertainty, a consolidation of

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