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Ferreira-Alfaya FJ, Zarzuelo-Romero MJ, Cura Y. Pharmaceutical pictograms to improve textual comprehension: A systematic review. Res Social Adm Pharm 2024; 20:75-85. [PMID: 38030546 DOI: 10.1016/j.sapharm.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 11/19/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Written instructive information for the patient is key in pharmaceutical care. However, the preexisting literature agrees on the discordance between the readability of written medication messages intended for patients. The aim of our work was to systematically review the available evidence on the effect of pharmaceutical pictograms as elements that facilitate understanding of the text in primary or secondary medication packaging. METHODS A parallel systematic search was conducted of the literature covering evidence of the effect of including pictograms in primary or secondary packaging on comprehension by potential users or caregivers up to April 9, 2023. The databases consulted were Scopus, MEDLINE and Web of Science. Only randomized controlled studies, whose main outcome measure was comprehension, were included. RESULTS Only 8 papers met our search criteria. In most of the included studies, the intervention of including pictograms improved participants' performance in comprehending instructions. A debatable methodological quality, and differences in the target population, textual complexity of the materials or the cultural affinity of the pictograms with the target population in each study, could have had a decisive influence on the results. CONCLUSION The heterogeneity in the design of each study poses a significant barrier to establishing commonalities and generalizing the results. This heterogeneity also prevented us from conclusively confirming the usefulness of pictograms complementary to instructional text in improving the comprehension of instructions for the rational use of medicines.
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Affiliation(s)
| | | | - Yasmin Cura
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Granada, Spain
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Kohut K, Speight B, Young J, Way R, Wiggins J, Monje-Garcia L, Eccles DM, Foster C, Turner L, Snape K, Hanson H. Co-design of patient information leaflets for germline predisposition to cancer: recommendations for clinical practice from the UK Cancer Genetics Group (UKCGG), Cancer Research UK (CRUK) funded CanGene-CanVar Programme and the Association of Genetic Nurse Counsellors (AGNC). J Med Genet 2024; 61:142-149. [PMID: 38050080 DOI: 10.1136/jmg-2023-109440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/27/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Testing for germline pathogenic variants (GPVs) in cancer predisposition genes is increasingly offered as part of routine care for patients with cancer. This is often urgent in oncology clinics due to potential implications on treatment and surgical decisions. This also allows identification of family members who should be offered predictive genetic testing. In the UK, it is common practice for healthcare professionals to provide a patient information leaflet (PIL) at point of care for diagnostic genetic testing in patients with cancer, after results disclosure when a GPV is identified, and for predictive testing of at-risk relatives. Services usually create their own PIL, resulting in duplication of effort and wide variability regarding format, content, signposting and patient input in co-design and evaluation. METHODS Representatives from UK Cancer Genetics Group (UKCGG), Cancer Research UK (CRUK) funded CanGene-CanVar programme and Association of Genetic Nurse Counsellors (AGNC) held a 2-day meeting with the aim of making recommendations for clinical practice regarding co-design of PIL for germline cancer susceptibility genetic testing. Lynch syndrome and haematological malignancies were chosen as exemplar conditions. RESULTS Meeting participants included patient representatives including as co-chair, multidisciplinary clinicians and other experts from across the UK. High-level consensus for UK recommendations for clinical practice was reached on several aspects of PIL using digital polling, including that PIL should be offered, accessible, co-designed and evaluated with patients. CONCLUSIONS Recommendations from the meeting are likely to be applicable for PIL co-design for a wide range of germline genetic testing scenarios.
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Affiliation(s)
- Kelly Kohut
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
- Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Beverley Speight
- Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Rosalind Way
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Jennifer Wiggins
- Cancer Genetics, The Royal Marsden NHS Foundation Trust, London, UK
| | - Laura Monje-Garcia
- The St Mark's Centre for Familial Intestinal Cancer, London North West University Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Claire Foster
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | | | - Katie Snape
- Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
- St George's University of London, London, UK
| | - Helen Hanson
- Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
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Samorek W, Przylepa J, Urbaniak J, Rogala A, Pilimon A, Błochowiak K, Błochowiak K. Assessment of Preferences in Taking Painkillers among Students of Medicine, Dentistry, and Pharmacy: A Pilot Study. Healthcare (Basel) 2024; 12:196. [PMID: 38255084 PMCID: PMC10815322 DOI: 10.3390/healthcare12020196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Students of pharmacy, medicine, and dentistry are important for shaping drug policy. The aim of this study is to assess and compare students preferences in taking painkillers. The study group consists of 382 students of pharmacy (28.8%), medicine (40.0%), and dentistry (30.1%). An anonymous questionnaire consisting of 17 questions was prepared using the Google Forms platform and distributed through social media. Ibuprofen was the most frequently preferred, regardless of the study major (57.8%). Pharmacy students expressed the least concern about the possible side effects of analgesics (17.5%). The fast onset of painkillers was more important for dental students (59.1%) and pharmacy students (44.7%), compared to medical students (39.22%). Medicine and pharmacy students indicated their studies to be their main source of information about painkillers compared to dentistry students (p = 0.001). There are no differences in pain severity regarding which analgesics are used among student groups (p = 0.547). Dental students experienced odontogenic pain less frequently (57.3%) than medical (79.7%) and pharmacy students (79.8%), (p = 0.000). Ketoprofen was the most frequently chosen prescription painkiller for odontogenic pain in all groups (49.4%). Gastrointestinal complaints were the most often reported side effects, regardless of the study major (87.1%). Choice of studies, gender, and year of study were the most important determinants of the choice of painkillers.
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Affiliation(s)
- Wiktoria Samorek
- Department of Oral Surgery, Periodontal Diseases and Oral Mucosal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.S.); (J.P.); (J.U.); (A.R.); (A.P.)
| | - Joanna Przylepa
- Department of Oral Surgery, Periodontal Diseases and Oral Mucosal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.S.); (J.P.); (J.U.); (A.R.); (A.P.)
| | - Joanna Urbaniak
- Department of Oral Surgery, Periodontal Diseases and Oral Mucosal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.S.); (J.P.); (J.U.); (A.R.); (A.P.)
| | - Aleksandra Rogala
- Department of Oral Surgery, Periodontal Diseases and Oral Mucosal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.S.); (J.P.); (J.U.); (A.R.); (A.P.)
| | - Anna Pilimon
- Department of Oral Surgery, Periodontal Diseases and Oral Mucosal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.S.); (J.P.); (J.U.); (A.R.); (A.P.)
| | | | - Katarzyna Błochowiak
- Department of Oral Surgery, Periodontal Diseases and Oral Mucosal Diseases, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (W.S.); (J.P.); (J.U.); (A.R.); (A.P.)
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Ahmadzadeh K, Bahrami M, Zare-Farashbandi F, Adibi P, Boroumand MA, Rahimi A. Patient education information material assessment criteria: A scoping review. Health Info Libr J 2023; 40:3-28. [PMID: 36637218 DOI: 10.1111/hir.12467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 10/13/2022] [Accepted: 11/03/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Patient education information material (PEIM) is an essential component of patient education programs in increasing patients' ability to cope with their diseases. Therefore, it is essential to consider the criteria that will be used to prepare and evaluate these resources. OBJECTIVE This paper aims to identify these criteria and recognize the tools or methods used to evaluate them. METHODS National and international databases and indexing banks, including PubMed, Scopus, Web of Science, ProQuest, the Cochrane Library, Magiran, SID and ISC, were searched for this review. Original or review articles, theses, short surveys, and conference papers published between January 1990 and June 2022 were included. RESULTS Overall, 4688 documents were retrieved, of which 298 documents met the inclusion criteria. The criteria were grouped into 24 overarching criteria. The most frequently used criteria were readability, quality, suitability, comprehensibility and understandability. CONCLUSION This review has provided empirical evidence to identify criteria, tools, techniques or methods for developing or evaluating a PEIM. The authors suggest that developing a comprehensive tool based on these findings is critical for evaluating the overall efficiency of PEIM using effective criteria.
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Affiliation(s)
- Khadijeh Ahmadzadeh
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Commitee, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Masoud Bahrami
- Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Payman Adibi
- Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Boroumand
- Department of Medical Library and Information Sciences, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rahimi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Pongpunna S, Wongtaweepkij K, Pratipanawatr T, Jarernsiripornkul N. Evaluation of patient comprehension and quality of consumer medicine information. Pharm Pract (Granada) 2022; 20:2730. [PMID: 36793918 PMCID: PMC9891795 DOI: 10.18549/pharmpract.2022.4.2730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/07/2022] [Indexed: 12/14/2022] Open
Abstract
Background Consumer medicine information (CMI) is voluntarily produced by pharmaceutical manufacturers in Thailand, but quality assessment of Thai-CMI is not routinely performed. Objective This study aimed to evaluate the content and design quality of CMI available in Thailand and assess patient understanding of the medicine information provided. Methods A cross-sectional study that consisted of two phases. Phase 1 was expert assessment of CMI using 15-item content checklists. Phase 2 was patient assessment of CMI by user-testing and the Consumer Information Rating Form. Participants (n=130) were outpatients aged 18 years or older with an educational level of less than grade 12. Self-administered questionnaires were distributed to patients at two university-affiliated hospitals in Thailand. Results A total of 60 CMI produced by 13 Thai pharmaceutical manufacturers were included in the study. Most of the CMI contained essential information about the medicines, but lacked information about serious adverse effects, maximum dose, warnings, and use in specific patient groups. Of 13 CMI selected for user-testing, none met the passing criteria with only 40.8% - 70.0% of answers found in the correct position and answered correctly. The mean values of patients' rating the CMI were between 2.5 (SD=0.8) and 3.7 (SD=0.5) for utility on a 4-point scale, and 2.3 (SD=0.7) to 4.0 (SD=0.8) for comprehensibility and 2.0 (SD=1.2) to 4.9 (SD=0.3) for design quality on a 5-point scale. Eight CMI were rated as poor (less than 3.0) for font size. Conclusion More safety information about medications should be included in Thai CMI and the design quality must be improved. CMI needs to be evaluated before distribution to consumers.
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Affiliation(s)
- Supawinee Pongpunna
- MPharm. Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand.
| | - Kamonphat Wongtaweepkij
- PhD. Division of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok, Thailand.
| | | | - Narumol Jarernsiripornkul
- PhD. Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand.
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Comprehension of an Over-the-Counter Drug Facts Label Prototype for a Mifepristone and Misoprostol Medication Abortion Product. Obstet Gynecol 2022; 139:1111-1122. [DOI: 10.1097/aog.0000000000004757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/20/2022] [Indexed: 11/27/2022]
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Health Literacy Level and Comprehension of Prescription and Nonprescription Drug Information. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116665. [PMID: 35682249 PMCID: PMC9180079 DOI: 10.3390/ijerph19116665] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the level of misunderstanding of medication information in Korean adults after stratifying by level of health literacy and to identify the factors influencing the misunderstanding of medication information and reading amounts of information on OTC drug labels. A cross-sectional survey was performed with 375 adult participants using the survey instrument. Multiple linear regression analyses were performed to identify factors which influence misunderstanding of medication information. Participants misunderstood 20% of words on OTC drug labels, 9% of prescription drug instructions, and 9% of pictograms. Participants on average read 59% of the overall contents of the OTC drug labels. As prescription drugs’ dosing regimens became more complicated, the level of misunderstanding instructions increased. The level of misunderstanding words on OTC drug labels significantly decreased as participants had adequate health literacy (β = −18.11, p < 0.001) and higher education levels (β = −6.83, p < 0.001), after adjusting for the study variables. The level of misunderstanding instructions for prescription drugs increased as participants became older (β = 8.81, p < 0.001) and had lower education levels (β = −5.05, p < 0.001), after adjusting for the study variables. The level of misunderstanding pictograms was similar to that of misunderstanding instructions for prescription drug labels. The amount of reading information on OTC drug labels significantly increased as respondents had adequate health literacy (β = 9.27, p < 0.001), were older (β = 12.49, p < 0.001), or had chronic diseases (β = 7.49, p = 0.007). Individuals’ health literacy level, reading behaviors, and complexity of medication instructions are associated with misunderstanding of medication information. Appropriate word choices in drug labels and an improved format of medication instructions could increase understanding of medication information and prevent adverse drug reactions.
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Zheng Y, Tang Y, Tseng HC, Chang TH, Li L, Chen P, Tang Y, Lin XB, Chen X, Tang KJ. Evaluation of quality and readability of over-the-counter medication package inserts. Res Social Adm Pharm 2022; 18:3560-3567. [DOI: 10.1016/j.sapharm.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/10/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
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Huang YM, Chen LJ, Hsieh LL, Chan HY, Chen-Liu KCS, Ho YF. Evaluation of use, comprehensibility and clarity of over-the-counter medicine labels: Consumers' perspectives and needs in Taiwan. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:753-761. [PMID: 33034423 DOI: 10.1111/hsc.13190] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/25/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
An estimate of one third of preventable medication errors occurred annually due to patients' misunderstanding of use instructions. To safeguard consumers' over-the-counter (OTC) medicine use and to develop future initiatives, this study evaluated the use, comprehensibility and clarity of the information labels on OTC packages from consumers' perspectives in Taiwan. This cross-sectional study was conducted at 29 community pharmacies; 50 pharmacy clerkship students helped participant enrolment from June to September 2017. Participants (n = 470) were 20 years old or above, Mandarin speaking, and with specific OTC purchases. A face-to-face survey was administered to investigate the degree to which participants read the package labels and their comprehension of correct medicine use. An 11-item survey was used to measure participants' specific OTC purchases (3 items), the use (2 items), comprehensibility (1 item) and clarity (2 items) of OTC package labels, in addition to the sociodemographic information (3 items). Participants were also solicited to provide opinions regarding package label redesign. Descriptive statistics and logistic regressions were applied for analyses. Findings show that most (84.0%) participants read instruction labels before use, with indications (79.4%), drug names (64.5%) and dosage and administration (59.8%) being the top reads. Only 30.0% of the participants fully understood how to take the medicines correctly. Younger (OR = 1.033, p < .001) and female participants (OR = 1.965, p = .014) with a higher level of education (OR = 1.940, p = .034) tended to read package label information prior to purchase or use. Younger participants (OR = 1.030, p < .001) and those who read OTC medicine labels before use (OR = 2.317, p = .004) were more likely to correctly understand medicine use. The findings indicate that older, male adults with a lower level of education should be targeted to ensure their correct understanding of OTC labels. Pharmacists should recite pertinent label information and, concomitantly, ensure consumers' understanding when providing medicine counselling.
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Affiliation(s)
- Yen-Ming Huang
- Department of Allied and Population Health, College of Pharmacy and Allied Health Professions, South Dakota State University, Brookings, SD, USA
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Ling-Ling Hsieh
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsun-Yu Chan
- Department of Psychology and Special Education, Texas A&M University-Commerce, TX, USA
| | - Karin C S Chen-Liu
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yunn-Fang Ho
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
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Readability, accuracy and comprehensibility of patient information leaflets: The missing pieces to the puzzle of problem-solving related to safety, efficacy and quality of medication use. Res Social Adm Pharm 2021; 18:2557-2558. [PMID: 34711520 DOI: 10.1016/j.sapharm.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 11/22/2022]
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Rubio-Rask SE, Farver-Vestergaard I, Hilberg O, Løkke A. Sexual health communication in COPD: The role, contents and design of patient information leaflets. Chron Respir Dis 2021; 18:14799731211020322. [PMID: 34189938 PMCID: PMC8252346 DOI: 10.1177/14799731211020322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Understanding need for support and information among people with COPD is important for the delivery of patient-centred care. Especially regarding intimacy matters, many people wish to remain sexually active but may be struggling to find out how, as information and communication regarding sexual health is scarce. This is especially true when it comes to people with chronic obstructive pulmonary disease (COPD). The present review seeks to provide an overview of the role, contents and design of patient information leaflets (PILs) and discuss their application in sexual health communication for COPD. Based on the literature, a number of key points in the design of high-quality PILs are suggested, and important areas for the improvement of patients-clinician communication are highlighted. While PILs is a commonly used format to provide information in healthcare, other formats, e.g. video and podcasts, could be explored. Prioritizing the development of material to support communication in the future is necessary to address the needs of both patients and caregivers and to support clinicians in initiating conversations about sexual health and intimacy matters.
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Affiliation(s)
| | | | - Ole Hilberg
- Department of Medicine, Vejle Hospital, Vejle, Denmark
| | - Anders Løkke
- Department of Medicine, Vejle Hospital, Vejle, Denmark
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12
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Using change detection to objectively evaluate whether novel over-the-counter drug labels can increase attention to critical health information among older adults. COGNITIVE RESEARCH-PRINCIPLES AND IMPLICATIONS 2021; 6:40. [PMID: 34041617 PMCID: PMC8153101 DOI: 10.1186/s41235-021-00307-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 05/14/2021] [Indexed: 11/10/2022]
Abstract
Over-the-counter (OTC) drugs have many benefits but also carry risks, such as adverse drug reactions, which are more prevalent in older adults. Because these products do not require the oversight of a physician or pharmacist, labeling plays a key role in communicating information required for their safe and effective use. Research suggests that current labels are not terribly effective at communicating potential risk. One reason for their lack of effectiveness is that few consumers attend to critical information (active ingredients and warnings) when making purchases. In two experiments, we used a change detection task to objectively evaluate how novel label designs that employ highlighting and a warning label placed on the package’s front impact attention to critical information among older participants (65 and older). The change detection task is a unique form of visual search which allowed us to assess the attentional priority of critical information among participants who were not explicitly instructed to search for this critical information. This unique aspect of the task is important given research suggesting that consumers rarely have the explicit goal of seeking out warnings and active ingredients when making OTC selections. Our results provide empirical support that both highlighting critical information and positioning it on the package’s front increase its attentional prioritization relative to current, commercial practice. Given that attending to the critical information is prerequisite to utilizing that information, strategies that elicit attention in this way are likely to reduce medication errors.
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Duyster T, McMillan SS, Whately E, Kelly FS. What Do Young Adults Think about the Safety of Over-the-Counter Analgesics? Findings from a Cross-Sectional Survey. PHARMACY 2021; 9:54. [PMID: 33807954 PMCID: PMC8005976 DOI: 10.3390/pharmacy9010054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/30/2022] Open
Abstract
Analgesics are commonly used over-the-counter (OTC) medicines readily available for purchase, sometimes without advice of a health professional. However, analgesics can cause harm even when taken according to dosing recommendations. Young adults may be more vulnerable to harm if they perceive low risk with OTC analgesic use, or struggle to interpret dosing instructions. This study aimed to explore factors affecting how young adults use OTC analgesics and associated perceptions of safety. An online survey was distributed to school-leavers and university students (17 to 25 years), in South-East Queensland, Australia, in the period November-December 2019. Most of the 302 respondents (school-leavers n = 147, university students n = 155) did not use analgesics frequently. School-leavers deferred to parents for analgesic information, while university students preferred the internet. The majority of respondents appeared safety conscious and did not take outside indicated use or instructions. However, a small proportion reported taking analgesics for an inappropriate indication. The difference in preferred source of analgesic information may reflect experience with analgesic use, increasing autonomy or decreased parental influence. Whilst it is encouraging that the majority of young adults appeared safety conscious, greater insight is needed into factors influencing decision making on OTC use, e.g., medicines knowledge, and changes with increasing age.
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Affiliation(s)
- Tahlia Duyster
- School of Pharmacy and Pharmacology, Gold Coast Campus, Griffith University, Southport 4215, Australia; (T.D.); (S.S.M.); (E.W.)
- Gold Coast Hospital and Health Service, Southport 4215, Australia
| | - Sara S. McMillan
- School of Pharmacy and Pharmacology, Gold Coast Campus, Griffith University, Southport 4215, Australia; (T.D.); (S.S.M.); (E.W.)
| | - Ella Whately
- School of Pharmacy and Pharmacology, Gold Coast Campus, Griffith University, Southport 4215, Australia; (T.D.); (S.S.M.); (E.W.)
- Gold Coast Hospital and Health Service, Southport 4215, Australia
| | - Fiona S. Kelly
- School of Pharmacy and Pharmacology, Gold Coast Campus, Griffith University, Southport 4215, Australia; (T.D.); (S.S.M.); (E.W.)
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14
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Wongtaweepkij K, Corlett S, Krska J, Pongwecharak J, Jarernsiripornkul N. Patients' Experiences and Perspectives of Receiving Written Medicine Information About Medicines: A Qualitative Study. Patient Prefer Adherence 2021; 15:569-580. [PMID: 33727802 PMCID: PMC7955729 DOI: 10.2147/ppa.s298563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/18/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Written medicine information informs patients about the benefits and risks of medicines and supports their safe and effective use. In Thailand, patient information leaflets (PILs) are not obligatory and therefore not routinely supplied. This study aimed to explore the experiences and information needs of patients, their views on PILs and the likely impact of PILs on their knowledge, perceptions and behaviors towards medicines. These factors are important to establish the value of PILs. METHODS Semi-structured interviews with outpatients who received simvastatin or atorvastatin were conducted exploring their experiences of receiving medicine information, their views on the utility of and need for PILs, the impact of PILs on their behaviors, and recommendations for how PILs could be improved. All interviews were audio-recorded, transcribed verbatim, and analyzed using a framework approach. RESULTS Thirty interviews were conducted from which four themes emerged: experience of receiving medicine information, views of package inserts and PILs, impact of PILs on knowledge, perceptions and behaviors, and patients' need for medicine information. Most participants received verbal information from healthcare professionals, as well as written information. Verbal information was perceived as being particularly useful to inform about changes to medicine regimens or the long-term adverse effects of medicines. Patients perceived that the PILs had influenced their knowledge about medicines, and also their behaviors including safety awareness, adherence, and engagement with healthcare professionals. Participants suggested that the information in electronic format could provide an additional resource. Some changes to improve the content and general format of the PIL were identified. CONCLUSION PILs are perceived as useful by patients and met their information needs, although they were viewed as an adjunct to verbal advice provided by healthcare professionals. PILs influenced patients' medicine taking behaviors and encouraged sharing of information with their physicians.
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Affiliation(s)
- Kamonphat Wongtaweepkij
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Sarah Corlett
- Medway School of Pharmacy, The Universities of Greenwich and Kent, Kent, UK
- Sarah Corlett Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham, Maritime, Kent, UK Email
| | - Janet Krska
- Medway School of Pharmacy, The Universities of Greenwich and Kent, Kent, UK
| | - Juraporn Pongwecharak
- Pharmacy Practice and Management Research Unit, Division of Pharmaceutical Care, Faculty of Pharmacy, Rangsit Center, Thammasat University, Pathumthani, Thailand
| | - Narumol Jarernsiripornkul
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Correspondence: Narumol Jarernsiripornkul Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand Email
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Kudzinesta M, Mubita M, Kalemeera F, Godman B, Hango E, Kibuule D. Utility of medicines information leaflets in hypertensive care in a setting with low health literacy: A cross-sectional study. MEDICINE ACCESS @ POINT OF CARE 2020; 4:2399202620910031. [PMID: 36204088 PMCID: PMC9413747 DOI: 10.1177/2399202620910031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 02/05/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: Higher levels of health literacy improve utilization of health information,
medication adherence and outcomes. Few studies evaluate the utility of
medicines information in hypertensive care in settings with low health
literacy. Aim: To determine the level of health literacy and utility of medicines
information leaflets (MILs) among hypertensive patients in public health
care in Namibia. Methods: A hospital-based survey among hypertensive patients receiving care at a
referral hospital in Namibia from the 8 June 2018 to 29 June 2018. Patient’s
health literacy and utility of MIL were assessed using three literacy tools
and a survey questionnaire. Quantitative data were analysed using
descriptive statistics and qualitative thematic content analysis for factors
associate with the utility of the MIL. Results: Of the 139 patients, 63% were female and the mean age was 45.7 (range:
19.0–84.0) years. Over 85.6% had of low literacy skills (Rapid Estimate of
Literacy in Medicine (REALM) score <44, that is, unable to read simple
health materials), 38.8% had positive Single Item Literacy Screener (SILS)
scores (⩾2, require help to read medicines information) and 66.9% had
inadequate skills for comprehension, appraisal and decision-making with
regard to health information (Health Literacy Skills Instrument-Short Form
(HLSI-SF) score <70%). The level of access to and utility of MIL were
low, 32.4% and 34.6%, respectively. The main factors associated with poor
utility of the MIL were low patient health literacy, lack of guidelines on
the use of MIL and MIL written in non-native languages. Conclusion: Low rates of health literacy and utility of MIL were observed among
hypertensive patients in Namibia. The integration of health literacy
programmes, and MIL guidelines are needed to promote utility of medicine
information and improve medication adherence.
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Affiliation(s)
| | - Mwangana Mubita
- Pharmacy Practice and Policy, University of Namibia, Windhoek, Namibia
| | - Francis Kalemeera
- Pharmacology and Therapeutics, University of Namibia, Windhoek, Namibia
| | - Brian Godman
- Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Ester Hango
- Pharmacy Practice and Policy, University of Namibia, Windhoek, Namibia
| | - Dan Kibuule
- Pharmacy Practice and Policy, University of Namibia, Windhoek, Namibia
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Arandy DA, Abu-Hashia MW, Al-hroub BM, Qatmosh SA, Koni AA, Qeeno BG, Al-Jabi SW, Zyoud SH. Comparative evaluation of drug information leaflets for non-steroidal anti-inflammatory drugs in Palestine: local versus imported products. BMC Health Serv Res 2019; 19:892. [PMID: 31771571 PMCID: PMC6880552 DOI: 10.1186/s12913-019-4754-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 11/19/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Drug information leaflets (DILs) are written for patients and health care providers to show how to use the medications safely and effectively, in order to reach the required therapeutics outcomes. This comparative study was conducted to evaluate various DILs of non-steroidal anti-inflammatory drugs (NSAIDs) that are produced in Palestine, along with their imported equivalents. METHODS Thirty-five DILs of NSAIDs were analyzed and evaluated in a cross-sectional comparative study. Thirty-one statements were obtained from literature and used; evaluation was performed on basis of both any presence or absence of these statements in the leaflets. 23 of the 31 statements that were available in both local and imported DILs were also evaluated in terms of total word-counts: the median (interquartile range) word-count for each statement was determined separately for the two groups and then compared. For the remaining 8 statements, this was not performed,either because they were not present in any leaflet, or because counting the number of words would not be meaningful. RESULTS A total of 35 DILs for nine different active ingredients of NSAIDs were analyzed. In 97% of leaflets, "Instructions to convert medication into liquid forms" were missing and 94% did not provide any information about "Pharmacokinetics". 83% of DILs provided no information about "Mechanism of action" and 74% did not mention any reliable references. 66% of the analyzed inserts did not include any instruction about the possibility of a tablet splitting. And in 63%, the "Date of last revision" was missing. Further, "Duration of using" and "Inactive ingredients" were not found in 51% of leaflets. In terms of word-count, the related sections of the 23 selected criteria were expressed with more words by imported leaflets compared with the local ones, significant differences were found in 12 categories, the highest significance of > 42.4-fold difference was found in "Geriatric considerations" category whereas 1.4-fold difference was found in "Shelf life," being the lowest one. CONCLUSIONS This study shows that local products provide less information than imported products, so we recommend that appropriate measurements be taken by both Palestinian authorities and manufacturers to improve both quantity and quality of local DILs.
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Affiliation(s)
- Dina A. Arandy
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Maysa W. Abu-Hashia
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Bahaa M. Al-hroub
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sandra A. Qatmosh
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Amer A. Koni
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Baraa G. Qeeno
- PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samah W. Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- Clinical Research Centre, An-Najah National University Hospital, Nablus, 44839 Palestine
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Perrot S, Cittée J, Louis P, Quentin B, Robert C, Milon JY, Bismut H, Baumelou A. Self-medication in pain management: The state of the art of pharmacists' role for optimal Over-The-Counter analgesic use. Eur J Pain 2019; 23:1747-1762. [PMID: 31349370 DOI: 10.1002/ejp.1459] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/01/2019] [Accepted: 07/20/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND OBJECTIVE Self-medication is associated with an important utilization of Over-The-Counter (OTC) analgesics. The medical outcome resulting from therapeutic options bypassing the physician prescription is a major issue. In that context, pharmacists are expected to play a crucial role. The main objective of this review was to analyse the state-of-the art of pharmacists' role in pain management self-medication. DATABASES AND DATA TREATMENT An expert multidisciplinary group dedicated to self-medication in pain was established. Selection of publications was performed from PubMedand EMBASE databases which was based on the use of "pain" and/or "self-medication" and/or "self-care" and/or "analgesics" and/or "painkillers" keywords, restricted to the past 10 years. RESULTS A total of 480 papers were identified, 49 of which papers were considered relevant and finally kept for final discussion, on OTC pain management and pharmacist's role. Literature analysis demonstrates that OTC analgesics are generally safe when appropriately used. Risks associated with misuse or inappropriateness depend on patients' vulnerability (elderly, pregnancy) or behaviour. Social cognitive theory-based intervention and multimedia applications improve self-medication but do not replace health care professional advice Pharmacists' interventions may improve the benefits and safety of OTC analgesic medication, with a better management of pain. CONCLUSIONS Considering the heterogeneity of patients' knowledge and behaviour reported worldwide, inappropriate use of OTC pain medication should not be underestimated. Community pharmacists are ideally placed to guide self-medication or recommend a medical advice when needed. Embedding pharmacists in primary care pain management is essential and pharmacist-led medication coupled with an appropriate training of pharmacy staffs should be encouraged. SIGNIFICANCE Analgesics are widely used without prescription, all over the world. They represent the largest market of OTC drugs, with an overall benefit/risk ratio favourable when appropriately used. Because of potential individual risks associated to the ailment or to the patient's behaviour, pharmacists' interventions have proven to optimize analgesic self-medication, provided that pharmacy staffs are both available and more specifically trained. In the future, in pain management, especially self-medication, pharmacists should play an increasing role and should be included in educational programmes and pain management guidelines.
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Affiliation(s)
| | - Jacques Cittée
- Department of General Medicine, Paris-Est University, Créteil, France
| | | | - Bertrand Quentin
- LIPHA-PE Hannah Arendt Institute, Paris-Est University, Marne-la Vallée, France
| | | | | | | | - Alain Baumelou
- Nephrology Deparment, La pitié-Salpêtrière Hospital, Paris, France
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Barnes LAJ, Barclay L, McCaffery K, Aslani P. Factors influencing women's decision-making regarding complementary medicine product use in pregnancy and lactation. BMC Pregnancy Childbirth 2019; 19:280. [PMID: 31390996 PMCID: PMC6686446 DOI: 10.1186/s12884-019-2396-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/02/2019] [Indexed: 12/20/2022] Open
Abstract
Background The prevalence of complementary medicine product (CMP) use by pregnant or breastfeeding Australian mothers is high, however, there is limited data on factors influencing women’s decision-making to use CMPs. This study explored and described the factors influencing women’s decisions take a CMP when pregnant or breastfeeding. Methods Qualitative in-depth interviews and focus group discussions were held with 25 pregnant and/or breastfeeding women who currently used CMPs. Participants’ health literacy was assessed using a validated single-item health literacy screening question and the Newest Vital Sign. Interview and focus group discussions were audio-recorded, transcribed verbatim and thematically analysed. Results Participants were a homogenous group. Most had higher education, medium to high incomes and high health literacy skills. They actively sought information from multiple sources and used a reiterative collation and assessment process. Their decision-making to take or not to take CMPs was informed by the need to establish the safety of the CMPs, as well as possible benefits or harms to their baby’s or their own health that could result from taking a CMP. Their specific information needs included the desire to access comprehensive, consistent, clear, easy to understand, and evidence-based information. Women preferred to access information from reputable sources, namely, their trusted health care practitioners, and information linked to government or hospital websites and published research. A lack of comprehensive, clear, consistent, or evidence-based information often led to decisions not to take a CMP, as they felt unable to adequately establish its safety or benefits. Conversely, when the participants felt the CMPs information they collected was good quality and from reputable sources, it reassured them of the safety of the CMP in pregnancy and/or breastfeeding. If this confirmed a clear benefit to their baby or themselves, they were more likely to decide to take a CMP. Conclusions The participants’ demographic profile confirms previous research concerning Australian women who use CMPs during pregnancy and lactation. Participants’ high health literacy skills led them to engage in a reiterative, information-seeking and analysis process fuelled by the need to find clear information before making the decision to take, or not to take, a CMP. Electronic supplementary material The online version of this article (10.1186/s12884-019-2396-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Larisa Ariadne Justine Barnes
- The University of Sydney, School of Pharmacy and University Centre for Rural Health, Faculty of Medicine and Health, PO Box 3074, Lismore, NSW, 2480, Australia.
| | - Lesley Barclay
- The University of Sydney, University Centre for Rural Health and Sydney School of Public Health, Faculty of Medicine and Health, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
| | - Kirsten McCaffery
- The University of Sydney, Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, Edward Ford Building (A27), Sydney, NSW, 2006, Australia
| | - Parisa Aslani
- The University of Sydney, School of Pharmacy, Faculty of Medicine and Health, Rm N502, Pharmacy & Bank Building (A15), Science Rd, Camperdown, NSW, 2006, Australia
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Boon H, Bozinovski N. A Systematic Narrative Review of the Evidence for Labeling of Natural Health Products and Dietary Supplements. J Altern Complement Med 2019; 25:777-788. [DOI: 10.1089/acm.2018.0533] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Heather Boon
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
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20
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Pizzol TDSD, Moraes CG, Arrais PSD, Bertoldi AD, Ramos LR, Farias MR, Oliveira MA, Tavares NUL, Luiza VL, Mengue SS. Medicine package inserts from the users' perspective: are they read and understood? REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190009. [PMID: 30892472 DOI: 10.1590/1980-549720190009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 12/01/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The written information on medicines has been acknowledged as an important tool for health education. OBJECTIVE To analyze the use and understanding of medicine package inserts by users and assess sociodemographic and medical factors associated with their comprehension. METHOD Data in this analysis are part of the PNAUM National Survey - a cross-sectional population-based study conducted in Brazil. Descriptive statistics and the Pearson χ2 tests were performed to compare proportions between sociodemographic and medical characteristics, as well as use and understanding of medicine package inserts. RESULTS A total of 28.427 individuals responded to questions related to medicine package inserts. From these, 59.6% (95%CI 57.7 - 61.5) said they usually read the inserts, and 98.4% (95%CI 98.0 - 98.8) considered them necessary. Among people who read the medicine package inserts, more than half indicated difficulties with legibility (57.4%; 95%CI 55,2 - 59,6) and readability (54.1%; 95%CI 52.1 - 56.1). People from a lower education level reported greater difficulty in understanding them. CONCLUSION The larger portion of the population usually read medicine package inserts. Nevertheless, people have difficulty in reading and understanding them.
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Affiliation(s)
- Tatiane da Silva Dal Pizzol
- Medicines Production and Control Department, Pharmacy College and Post Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul - Porto Alegre, RS, Brazil
| | | | - Paulo Sérgio Dourado Arrais
- Pharmacy Department, Pharmacy, Odontology and Nursering College, Universidade Federal do Ceará - Fortaleza,CE, Brazil
| | - Andréa Dâmaso Bertoldi
- Social Medicine Department. Medicine College, Universidade Federal de Pelotas - Pelotas, RS, Brazil
| | - Luiz Roberto Ramos
- Preventive Medicine Department, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo, SP, Brazil
| | - Mareni Rocha Farias
- Pharmaceutical Sciences Department, Health Sciences Center, Universidade Federal de Santa Catarina - Florianópolis, SC, Brazil
| | | | | | - Vera Lucia Luiza
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz - Rio de Janeiro, RJ, Brazil
| | - Sotero Serrate Mengue
- Post Graduate Program in Epidemiology of Universidade Federal do Rio Grande do Sul - Porto Alegre, RS, Brazil
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Munsour EE, Awaisu A, Hassali MAA, Ali H, Dabbous Z. A comparative evaluation of written medicine information of antidiabetic medicines from Qatar, Australia and Europe. COGENT MEDICINE 2019. [DOI: 10.1080/2331205x.2019.1620904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Emad Eldin Munsour
- Pharmacy and Drug Control Department, Ministry of Public Health, Doha, Qatar
| | - Ahmed Awaisu
- College of Pharmacy, Qatar University, Doha, Qatar
| | | | - Hamda Ali
- Diabetes/Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Zeinab Dabbous
- Diabetes/Endocrinology, Hamad Medical Corporation, Doha, Qatar
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22
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Tong V, Raynor DK, Aslani P. Comparative User Testing of Australian and UK Over-the-Counter Labels and Leaflets for Diclofenac. Ther Innov Regul Sci 2018; 52:38-48. [DOI: 10.1177/2168479017711730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tong V, Raynor DK, Aslani P. Developing alternative over-the-counter medicine label formats: How do they compare when evaluated by consumers? Res Social Adm Pharm 2018; 14:248-261. [DOI: 10.1016/j.sapharm.2017.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 01/14/2017] [Accepted: 03/08/2017] [Indexed: 10/20/2022]
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Al Aqeel S, Abanmy N, Aldayel A, Al-Khalifa H, Al-Yahya M, Diab M. Readability of written medicine information materials in Arabic language: expert and consumer evaluation. BMC Health Serv Res 2018; 18:139. [PMID: 29482618 PMCID: PMC5828313 DOI: 10.1186/s12913-018-2944-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 02/19/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Written Medicine Information (WMI) is one of the sources that patients use to obtain information concerning medicine. This paper aims to assess the readability of two types of WMIs in Arabic language based on vocabulary use and sentence structure using a panel of experts and consumers. METHODS This is a descriptive study. Two different types of materials, including the online text from King Abdullah Bin Abdulaziz Arabic Health Encyclopaedia (KAAHE) and medication leaflets submitted by the manufacturers to the Saudi Food and Drug Authority (SFDA) were evaluated. We selected a group of sentences from each WMI. The readability was assessed by experts (n = 5) and consumers (n = 5). The sentence readability of each measured using a specific criteria and rated as 1 = easy, 2 = intermediate, or 3 = difficult. RESULTS A total of 4476 sentences (SFDA 2231; KAHEE 2245) extracted from websites or patient information leaflets on 50 medications and evaluated. The majority of the vocabulary and sentence structure was considered easy by both expert (SFDA: 68%; KAAHE: 76%) and consumer (SFDA: 76%; KAAHE: 84%) groups. The sentences with difficult or intermediate vocabulary and sentence structure are derived primarily from the precautions and side effects sections. CONCLUSIONS The SFDA and KAAHE WMIs are easy to read and understand as judged by our study sample. However; there is room for improvement, especially in sections related to the side effects and precautions.
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Affiliation(s)
- Sinaa Al Aqeel
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia.
| | - Norah Abanmy
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Abeer Aldayel
- Information Technology Department, College of Computer and Information Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Hend Al-Khalifa
- Information Technology Department, College of Computer and Information Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Maha Al-Yahya
- Information Technology Department, College of Computer and Information Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mona Diab
- Department of Computer Science, SEAS, The George Washington University, Washington, USA
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Tong V, Raynor DK, Hamrosi KK, Acharya B, Panchal N, Aslani P. Consumer Opinions on Existing and Proposed Australian Over-the-Counter Medicine Labeling Strategies in Comparison With the Standardized US Drug Facts Label. Ther Innov Regul Sci 2016; 50:427-435. [DOI: 10.1177/2168479016628301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Muller C, Bazin Kara D, Fourtage M, Ott J, Krummel T, Imhoff O, Garstka A, Richter S, Kolb I, Faller AL, Petit-Jean P, Kiener C, Alenabi F, Sissoko H, Léon É, Chantrel F, Dimitrov Y, Hannedouche T. [Compliance and leaflet's reading, which link and which media? Results from a French population with chronic kidney disease]. Nephrol Ther 2016; 12:443-447. [PMID: 27692384 DOI: 10.1016/j.nephro.2016.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/03/2016] [Accepted: 05/04/2016] [Indexed: 10/20/2022]
Abstract
Leaflets inside drug boxes are complex and often poorly understood. Patients consulting in nephrology are mostly old and often suffer from multiple comorbidities. As so, they are often subject to various contra-indications and drug interactions. This paper aims to evaluate if patients actually read leaflets or other medical information on others medias such as Internet and whether this could, potentially, interfere with their observance. Results showed that leaflets were read by 65.1% of patients, leading to 12% of withdrawal or not taking drugs. Furthermore, compliance to medical guidance was deemed e-read by 65.1% of patients, leading to 12% of withdrawal or not taken drugs. Furthermore, this study showed no clear profile for non-compliant patients. Even the youngest patients (under 50 years old) have had a good compliance, with not more withdrawal or not taking pills. Nonetheless, youngest patients used more often to consult alternative medias and did not read much of the leaflets' information. Patients who were reading leaflets however, tended to search further information on other medias. This situation would create new challenges in health care, as it seems that data available on new medias are not systematically validated or adapted to the needs of the patients.
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Affiliation(s)
- Clotilde Muller
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France.
| | - Dorothée Bazin Kara
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Marion Fourtage
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Julien Ott
- Service de néphrologie, hôpital d'Haguenau, 63, avenue du Pr-Leriche, 67500 Haguenau, France
| | - Thierry Krummel
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Olivier Imhoff
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Antoine Garstka
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Sarah Richter
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Isabelle Kolb
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Anne-Laure Faller
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Philippe Petit-Jean
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Clotilde Kiener
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Farideh Alenabi
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Henriette Sissoko
- Service de néphrologie, hôpital de Mulhouse, 20, avenue du Dr Laënnec, 68100 Mulhouse, France
| | - Émilie Léon
- Service de néphrologie, hôpital d'Haguenau, 63, avenue du Pr-Leriche, 67500 Haguenau, France
| | - François Chantrel
- Service de néphrologie, hôpital de Mulhouse, 20, avenue du Dr Laënnec, 68100 Mulhouse, France
| | - Yves Dimitrov
- Service de néphrologie, hôpital d'Haguenau, 63, avenue du Pr-Leriche, 67500 Haguenau, France
| | - Thierry Hannedouche
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
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Alaqeel S, Al Obaidi N. Patient Evaluation of Medication Package Leaflets in Al Kharj City, Saudi Arabia. Ther Innov Regul Sci 2016; 51:45-50. [PMID: 30235994 DOI: 10.1177/2168479016659320] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this study was to determine how well patients could correctly recognize and comprehend the various information items in over-the-counter (OTC) medications package leaflets in Saudi Arabia. METHODS Leaflets from 20 most commonly sold OTC medications were examined by experts to evaluate the leaflet layout, language, and content. The same leaflets were also evaluated by patients who had their medicines dispensed at 2 hospitals and 8 community pharmacies in Al Kharj, Saudi Arabia. A questionnaire was used for the patients' examination. RESULTS A total of 479 questionnaires were included in the study. Each package leaflet was examined by at least 20 participants. The results indicate poor comprehensibility, for many items, particularly items regarding "drug interactions" and "contraindications." CONCLUSION The participants had some difficulty recognizing and comprehending certain information items in the package leaflets that are supplied with OTC medications in Saudi Arabia.
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Affiliation(s)
- Sinaa Alaqeel
- 1 Clinical Pharmacy Department, King Saud University, Riyadh, Saudi Arabia
| | - Nahed Al Obaidi
- 2 Pharmacy services Department, King Khalid Hospital, Al Kharj, Saudi Arabia
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Lampert A, Wien K, Haefeli WE, Seidling HM. Guidance on how to achieve comprehensible patient information leaflets in four steps. Int J Qual Health Care 2016; 28:634-638. [PMID: 27512127 DOI: 10.1093/intqhc/mzw077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 11/14/2022] Open
Abstract
Comprehensible information leaflets can improve a patient's knowledge. However, in clinical studies leaflets are often introduced without meticulously verifying their comprehensibility. In an attempt to provide a feasible guidance on how to design comprehensible leaflets we complied and evaluated an easy-to-use development procedure. In January 2015, a literature search was performed to identify evidence for readily available quality assurance strategies as a starting point for a standardized strategy to develop and validate written patient information. The suggested development strategy is a consecutive four-step procedure that comprised already validated distinct quality assessments: (i) an initial requirement analysis specifying the needs and constraints of the target population and evidence-based preparation of the leaflets, (ii) a readability assessment, (iii) the Suitability Assessment of Materials instrument and (iv) iterative consumer test in the target population. The consecutive combination of pertinent and previously validated quality assessments provides an easy-to-use guidance on how to create comprehensibly written patient information, particularly for small-scale research projects with time and money constraints.
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Affiliation(s)
- Anette Lampert
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.,Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany
| | - Katharina Wien
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.,Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.,Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany
| | - Hanna M Seidling
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany.,Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany
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MacLure K, Paudyal V, Stewart D. Reviewing the literature, how systematic is systematic? Int J Clin Pharm 2016; 38:685-94. [PMID: 27048436 PMCID: PMC4909788 DOI: 10.1007/s11096-016-0288-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 03/14/2016] [Indexed: 12/28/2022]
Abstract
Introduction Professor Archibald Cochrane, after whom the Cochrane Collaboration is named, was influential in promoting evidence-based clinical practice. He called for "relevant, valid research" to underpin all aspects of healthcare. Systematic reviews of the literature are regarded as a high quality source of cumulative evidence but it is unclear how truly systematic they, or other review articles, are or 'how systematic is systematic?' Today's evidence-based review industry is a burgeoning mix of specialist terminology, collaborations and foundations, databases, portals, handbooks, tools, criteria and training courses. Aim of the review This study aims to identify uses and types of reviews, key issues in planning, conducting, reporting and critiquing reviews, and factors which limit claims to be systematic. Method A rapid review of review articles published in IJCP. Results This rapid review identified 17 review articles published in IJCP between 2010 and 2015 inclusive. It explored the use of different types of review article, the variation and widely available range of guidelines, checklists and criteria which, through systematic application, aim to promote best practice. It also identified common pitfalls in endeavouring to conduct reviews of the literature systematically. Discussion Although a limited set of IJCP reviews were identified, there is clear evidence of the variation in adoption and application of systematic methods. The burgeoning evidence industry offers the tools and guidelines required to conduct systematic reviews, and other types of review, systematically. This rapid review was limited to the database of one journal over a period of 6 years. Although this review was conducted systematically, it is not presented as a systematic review. Conclusion As a research community we have yet to fully engage with readily available guidelines and tools which would help to avoid the common pitfalls. Therefore the question remains, of not just IJCP but potentially all published reviews, 'how systematic is systematic?'
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Affiliation(s)
- Katie MacLure
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, AB10 7GJ, Scotland, UK.
| | - Vibhu Paudyal
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, AB10 7GJ, Scotland, UK
| | - Derek Stewart
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, AB10 7GJ, Scotland, UK
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Pires C, Vigário M, Cavaco A. Graphical content of medicinal package inserts: an exploratory study to evaluate potential legibility issues. Health Info Libr J 2015; 33:121-39. [PMID: 26640041 DOI: 10.1111/hir.12128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 10/19/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The graphical content of the Medicines Package Inserts (MPIs), such as illustrations and typographic features should be legible and appropriate, as required by international pharmaceutical regulations. OBJECTIVES To study: (1) the frequency and type of MPIs' key graphic elements, (2) their compliance with regulations and (3) how educated people understand them. METHODS Descriptive study: characterisation of the graphical content of 651 MPIs. Usability study: illustrations and tables (purposively selected) were evaluated with questionnaires in three groups of humanities undergraduates (illustrations only, illustrations plus text and text only). RESULTS Descriptive study: illustrations and tables were respectively identified in 6.3% and 11.8% of the MPIs. The illustrations were mainly related to how to take/use the medicine. Non-recommended graphical representations were found (e.g. italic or underline). Usability test: legibility issues were identified, especially for the group of isolated illustrations. DISCUSSION & CONCLUSIONS The scarce use of illustrations and tables possibly affected the legibility of the MPIs. Compulsory legibility tests are needed to guarantee the MPIs' proper use, thus contributing to a safe use of medicines. Overall, this study highlighted the need to carefully revise/assess the MPIs' design and probably increase health information experts' awareness on this issue.
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Affiliation(s)
- Carla Pires
- Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - Marina Vigário
- Centre of Linguistics of the University of Lisbon, School of Arts and Humanities, University of Lisbon, Lisbon, Portugal
| | - Afonso Cavaco
- Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
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Tong V, Raynor DK, Aslani P. 'It's all there in black and white' - or is it? Consumer perspectives on the proposed Australian Medicine Information Box over-the-counter label format. Health Expect 2015; 19:948-61. [PMID: 26230544 PMCID: PMC5042067 DOI: 10.1111/hex.12389] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2015] [Indexed: 11/27/2022] Open
Abstract
Background Over‐the‐counter (OTC) labels help support safe medication use by consumers. In 2012, the Australian Therapeutic Goods Administration (TGA) released a consultation paper proposing OTC label standardization to improve label quality via implementation of the Medicine Information Box (MIB) label. However, consumer opinions of the MIB and standardization of OTC labelling remain unexplored. Objective To explore consumer perspectives of OTC label standardization and the proposed MIB. Design Mock MIB labels were developed by the research team, guided by the TGA consultation paper, and used as interview stimulus material. Participants and setting Semi‐structured interviews were conducted with 38 Australian and 39 UK adult participants. Participant perspectives on OTC label standardization, opinions on the MIB and perceived improvements were explored. All interviews were audio‐recorded with permission, transcribed verbatim, and the content thematically analysed. Results Participants expressed a range of opinions towards OTC label standardization, from welcoming standardization to concern that important details may be overlooked. The MIB was generally positively received due to its perceived good information design and ease of navigation. Participants requested reordering of information‐specifically, for the active ingredient to be moved to a less prominent position. Suggested improvements centred on content and design changes, for example colour, pictograms, bolding. Conclusions Participants felt positively towards OTC label standardization and saw the MIB as a feasible standardized format to implement for OTC labels. Although they appreciated its good information design, they felt further improvements to its content and design are required to enhance its quality and usability.
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Affiliation(s)
- Vivien Tong
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | | | - Parisa Aslani
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
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