Patients assessed possible ADRs most often by considering timing relationships. While they also used medicine information, Thai patients received inadequate information to help them assess their symptoms. Patients expressed uncertainty and difficulties in deciding attribution when concomitant medicines and diseases were involved. The findings could support the development of a patient-friendly systematic tool for identifying and assessing possible ADRs.

*Background: Drug allergy a serious adverse drug reaction commonly concerned in healthcare practice. Inadequate documentation and communication between health providers, and limited health literacy and knowledge in patients could contribute to the re-occurrence of allergic reactions. Objective: To evaluate the effectiveness of initiatives aiming to improve patients' knowledge, understanding and behavior in preventing recurrent drug allergy. Methods: A before-and-after study was conducted at an 800-bed university teaching hospital, involving patients with a history of drug allergy. Questionnaires, completed at baseline and one month after receiving information were used to compare knowledge and understanding of drug allergy and behaviors in relation to drug allergy cards. Patients in Group 1 received a brochure only, but patients in Group 2 also received a pharmacist counseling intervention in addition to the brochure. Outcomes were evaluated within intervention group and between intervention groups. Results: The study included 299 (30.4%) and 100 patients (100.0%) in Groups 1 and 2 respectively who completed the baseline questionnaire, of whom 179 (59.8%) and 96 (96.0%) completed the follow-up questionnaire. At baseline, higher educational levels and possession of a drug allergy card were significantly associated with better knowledge about drug allergy. After intervention, Group 2 had significantly greater increases in mean overall knowledge scores than Group 1 (p<0.01) and also greater increases in the proportions self-reporting carrying and presenting drug allergy cards (p<0.05 and p<0.01). Conclusions: Pharmacist counseling plus brochure may be more effective than brochure alone in promoting patients' knowledge of drug allergy and drug allergy card importance.

Many patients experienced at least one possible adverse effects on a statin. The findings suggest that laboratory monitoring is relatively selective in relation to risks and patient-reported adverse symptoms.

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This novel instrument has satisfactory psychometric properties and was acceptable to Thai patients, but it requires further testing. It has potential for use in supporting patients with suspected ADRs to discuss these with health professionals, and perhaps to report directly.