title: Are patients aware of angiotensin-converting enzyme inhibitor-associated adverse effects?
abstract: It is important for patients to understand the potential adverse effects (AEs) of their daily medications. Because associated adverse effects (ACEIs) may result in life-threatening angioedema, we sought to assess patients' level of awareness of ACEI AEs, determine if patients have an appropriate action plan in the event of an ACEI AE, determine if a brief educational intervention in the emergency department (ED) could improve knowledge about ACEI AEs. This was a prospective in-person survey conducted between August and December 2008 in a large urban academic ED. The survey instrument was used to collect data on demographics, recognition of ACEI AEs, and action plans. A follow-up survey to assess recall of AEs was done 7 days after ED discharge. Of 208 eligible patients, 113 enrolled: sixty-five (58%) were females, median age was 55 years [interquartile range (IQR) 47-64]. The majority of participants (69%) had a high-school diploma or less. On a 5-point Likert scale (5 = "very important"), the median reported level of overall concern for ACEI AEs was 5 (IQR 4-5). Twenty-seven (25%) of the participants reported being told that ACEIs have potential AEs at the time of the initial prescription. Correct identification of potential ACEI-associated AEs in the ED was variable with a median of 8 of 16 correctly answered questions (IQR 6-10). At follow-up, the median score was 9 (IQR 6-10). There was no association between educational level and number of correct AE responses (P = 0.10). Despite a high level of expressed concern regarding ACEI AEs, patients' knowledge of AEs was poor, and recall was minimally improved at follow-up. Most patients have a plan in the event of an AE.
authors.affiliation: Boston University School of Medicine, MA, USA.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Khoubaeva
authors.forename: Kate
authors.initials: K
authors.lastname: Murray
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Mitchell
authors.forename: Hillary A
authors.initials: HA
authors.lastname: Zaniboni
authors.forename: James A
authors.initials: JA
authors.lastname: Feldman
authors.forename: Mark B
authors.initials: MB
authors.lastname: Mycyk
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D003625:Data Collection; D004522:Educational Status; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors