Drug Effects Questionnaire

In general, standardization ol questionnaires and their items helps to simplify quantitative comparisons between individuals and conditions but simultaneously curtails each individual statement and may force it into inappropriate categories. Moreover, allocating the same weight to all the items m a questionnaire, such as all pairs of opposite toms m a semantic differential, may iron out the effects of substances and obscure mterestmg individual effects. A freely formulated description of drug action, be it m oral or written form, should therefore be included m studies of this land... 

Subjective-effect studies require consideration of several experimental factors and control procedures. Participants must be able to comprehend and respond appropriately to questionnaires. Drugs should be administered under double-blind conditions to avoid the introduction of bias into participants reports. The participants prior drug exposure could influence responding most studies assessing abuse potential have used participants with histories of illicit drug use, though a number of studies have been conducted in healthy volunteers without histories of drug abuse.40,44-47... 

Most of the problems associated with the questionnaire were due to a lack of explicit hypotheses as to potential long-term effects of the drugs studied. Questions of general interest were included, but specific hypotheses were not assessed with questions. Furthermore, the survey instrument was a questionnaire, not an interview. The questions therefore had to be simple, easily understood, and able to be answered quickly. Such constraints limit the specificity and detail of the information to be collected. 

Discussion about tardive dyskinesia is necessary in the process of obtaining informed consent to treatment with neuroleptic drugs (SEDA-15, 46 SEDA-21, 42 SEDA-21, 45). The effect of education about tardive dyskinesia has been evaluated in 56 patients taking maintenance neuroleptic drugs, who completed a questionnaire assessing their knowledge of the condition (262). Education made patients more knowledgeable at 6 months, but had no effect on the clinical outcome. 

Other consequences of banning thioridazine have been reported in a rural general practice in Ireland, in which 29 of 40 GPs responded to a questionnaire and 17 reported management problems and adverse reactions (29). There was increased service demand, as 44% of the GPs described up to a 50% increase in referrals to the mental health service although most of the GPs (67%) reported satisfaction with alternative agents, 37% described adverse effects associated with the alternative agents. It seems reasonable that directives should incorporate the flexibility required to accommodate the needs of patients who are already successfully stabilized on these drugs. 

Other measures include the clinician s global assessment based on the patient s history of activities and limitations caused by OA, the Western Ontario and McMaster Universities Arthrosis Index, Stanford Health Assessment Questionnaire, and documentation of analgesic or NSAID use. Patients should be asked if they are having adverse effects from their medications. They should also be monitored for any signs of drug-related effects, such as skin rash, headaches, drowsiness, weight gain, or hypertension from NSAIDs. 

An asthma DM program can assist pharmacists in providing education to patients with asthma. Hunter and Bryant developed an educational intervention administered by pharmacists and targeted at pediatric asthma patients and their parents. The educational intervention consisted of a 45-min presentation, a demonstration of drug delivery devices, and a discussion session for participants to ask questions and share experiences. All the participants indicated on a questionnaire that they had received enough information to safely and effectively administer asthma medications. 

An unblinded questionnaire survey has been carried out to determine patients perceptions of differences in the efficacy, adverse effects, and value of omeprazole versus lansoprazole for gastro-esophageal reflux disease maintenance therapy (5). The patients had been taking omeprazole for at least 2 months and then switched to lansoprazole for a minimum of 2 months. There was no significant difference between median symptom scores with the two drugs, but 64% of patients preferred omeprazole to lansoprazole. The most commonly reported adverse effects with both drugs were flatulence, headache, and diarrhea. Significantly more patients reported adverse effects with lansoprazole than with omeprazole. 

One final common inclusion in many studies of occupational behavioral toxicology and in some test batteries is assessments of symptoms experienced by those exposed to chemicals. While this might be perceived as an ostensibly simple procedure, it entails numerous potential confounds. These evaluations are typically administered via questionnaires. Items for the questionnaire must be carefully constructed with respect to not only the choices of items but also the wording of the text and the manner in which the response is recorded. Clearly, the motivation of the subject in answering the questions must be considered. One problem can arise when the list of symptoms includes only those that are associated with the toxicant of concern. It is necessary to include symptoms that are not associated with the particular toxicant under evaluation so that some assessment of the tendency of the subject to respond positively to all symptoms can be evaluated. Several such evaluations of subjective and mood states are available. The most widely used is the Profile of Mood States (POMS), which consists of 65 adjectives of various moods that the subject answers according to a 5-point rating scale. The POMS has been used extensively in the evaluation of the acute effects of CNS drugs and toxicants. 

While the effects of /3-blockers on survival prolongation and left ventricular reverse remodeling could be argued to be greater than those of any other drugs used in heart failure, this is not the case for their symptomatic benefits. Many, but not all studies, have shown improvements in the NYHA functional class, patient symptom scores or quality-of-life assessments (such as the Minnesota Living with Heart Failure Questionnaire), and exercise performance, as assessed by the 6-minute walk test. Thus it is important to educate patients that they will not necessarily notice dramatic symptomatic improvements with /3-blocker therapy. However, even in the absence of symptomatic... 

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