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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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Desai S, Kainth T, Yadav G, Kochhar H, Srinivas S, Kamil S, Du W. Role of Psychosomatic Symptoms in COVID-19 Vaccine Hesitancy. Vaccines (Basel) 2023; 11:vaccines11050922. [PMID: 37243026 DOI: 10.3390/vaccines11050922] [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: 03/05/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Vaccination against COVID-19 is one of the highly effective preventative strategies to reduce morbidity and mortality associated with COVID-19 infection. The rapid approval of COVID-19 vaccination due to the raging pandemic, media coverage, anti-vaccination groups, and concerns about adverse effects associated with vaccination has given rise to COVID-19 vaccine hesitancy. Current evidence suggests that psychosomatic and nocebo-related adverse effects account for a significant proportion of common adverse effects following COVID-19 vaccination. The most common adverse effects are headache, fatigue, and myalgia, which are highly prone to nocebo effects. In our review article, we discuss the role of psychosomatic and nocebo effects in COVID-19 vaccination-related hesitancy, predictors of such effects, and strategies to reduce vaccine hesitancy. General education regarding psychosomatic and nocebo effects and specialized education for at-risk populations may reduce psychosomatic and nocebo-related adverse effects following COVID-19 vaccination, ultimately reducing hesitancy.
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Affiliation(s)
- Saral Desai
- Department of Psychiatry, Tower Health-Phoenixville Hospital, Phoenixville, PA 19460, USA
| | - Tejasvi Kainth
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794, USA
| | - Garima Yadav
- Department of Psychiatry, Bronx Care Health System, Bronx, NY 10456, USA
| | - Hansini Kochhar
- Department of Psychiatry, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Sushma Srinivas
- Department of Psychiatry, A.J. Institute of Medical Sciences and Research Center, Manglore 575004, India
| | - Saher Kamil
- Department of Pediatrics, Dell Children's Medical Center, Austin, TX 78723, USA
| | - Wei Du
- Academic Affairs, Tower Health, West Reading, PA 19611, USA
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, PA 19102, USA
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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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Wongtaweepkij K, Sup-adulchai N, Chanachoat J, Krska J, Jarernsiripornkul N. Evaluation of Medicine Information Leaflets for Omeprazole, Safety Knowledge, and Perceptions of Taking the Medication in Thailand. Patient Prefer Adherence 2023; 17:883-893. [PMID: 37009429 PMCID: PMC10064870 DOI: 10.2147/ppa.s397557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
PURPOSE This study aimed to compare package inserts and patient information leaflets for omeprazole in terms of the quality of and satisfaction with the written medicine information, medication safety knowledge, and perceived benefits and risks. PATIENTS AND METHODS A cross-sectional, comparative study was conducted at a university hospital in Thailand. Outpatients visiting the pharmacy departments prescribed omeprazole were randomly selected to receive either a package insert or a patient information leaflet. Medication safety knowledge was measured using a set of eight questions. The quality of the written medicine information was measured by the Consumer Information Rating Form. Perceived benefits and risks of the medication were rated using a visual analog scale. Linear regression was used to determine factors associated with perceived benefits and risks. RESULTS Of the 645 patients, 293 agreed to answer the questionnaire. 157 and 136 patients were given patient information leaflets and package inserts, respectively. Most respondents were female (65.6%), over half had a degree (56.2%). Patients reading the patient information leaflets had slightly higher overall safety knowledge scores than those reading the package inserts (5.88 ± 2.25 vs 5.25 ± 1.84, p=0.01). Using the Consumer Information Rating Form, the patient information leaflets were given significantly higher scores compared to the package inserts for comprehensibility (19.34±3.92 vs 17.32±3.52, p<0.001) and design quality (29.25 ± 5.00 vs 23.81 ± 5.16, p<0.001). After reading the leaflets, patients receiving the patient information leaflets had significantly higher satisfaction with the information provided (p=0.003). In contrast, those receiving the package inserts rated the risks of omeprazole higher (p=0.007). CONCLUSION Demonstrable differences were found from the patient perspective between a package insert and a patient information leaflet for the same medicine, mostly in favour of patient information leaflets. Medicine safety knowledge after reading PI and PIL was similar. However, receiving package inserts provided higher perceived risks from taking the medicine.
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Affiliation(s)
- Kamonphat Wongtaweepkij
- Division of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Nutchwarang Sup-adulchai
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Jirath Chanachoat
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Janet Krska
- Medway School of Pharmacy, University of Kent, Kent, UK
| | - 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, Tel +66-4334-8353, Fax +66-4320-2379, Email
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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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Bartmann B, Schallock H, Dubois C, Keinki C, Zomorodbakhsch B, Hartmann M, Hübner J. Internet Information on Oral Cancer Drugs: a Critical Comparison between Website Providers. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:983-993. [PMID: 33128211 PMCID: PMC9399062 DOI: 10.1007/s13187-020-01909-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/23/2020] [Indexed: 06/11/2023]
Abstract
Cancer patients need access to high-quality information, when making decisions about oral cancer drugs. The internet is often used as a source of information published by highly heterogeneous providers. The objective was to evaluate the quality of website providers supplying online information about oral cancer drugs. One hundred websites were analyzed using content-related and formal criteria, selected from three existing evaluation methods used for cancer websites, for medical information (defined by the German Agency for Quality in Medicine), and for the "fact box" tool. A web search by a patient was simulated to identify websites to evaluate. ANOVA was used to assess information provided by non-profit organizations (governmental and non-governmental), online newspapers, for-profit organizations, and private/unknown providers. Content-related quality differences were found between online newspapers and all other categories, with online newspapers ranking significantly lower than for-profit and non-profit websites. As for formal criteria, for-profit providers scored significantly lower than non-profit providers and online newspapers for the aspect of transparency. Internet information on oral cancer drugs published by non-profit organizations constitutes the best available web-based source of information for cancer patients. Health literacy and e-health literacy should be promoted in the public domain to allow patients to reliably apply web-based information. Certification should be required by law to ensure fulfillment of requirements for data reliability and transparency (authorship and funding) before health professionals recommend websites to cancer patients.
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Affiliation(s)
- Berit Bartmann
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Henriette Schallock
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Clara Dubois
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Christian Keinki
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | | | | | - Jutta Hübner
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
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Bechini A, Chiesi F, Giammarco B, Gori E, Di Tommaso M, Strambi N, Alti E, Picciolli P, Mereu G, Mori MG, Vitali Rosati G, Van Damme P, Bamberger M, Bonanni P, Boccalini S. Electronic Package Leaflets for Vaccines: What Are People’s Perceptions in Italy? Vaccines (Basel) 2022; 10:vaccines10071075. [PMID: 35891238 PMCID: PMC9323636 DOI: 10.3390/vaccines10071075] [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: 06/10/2022] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 02/04/2023] Open
Abstract
In Italy, the paper package leaflet (PPL) is the official document that is approved by the Italian Medicines Agency (AIFA) for each medicine. PPLs of all medicines, including vaccines, are freely available online by accessing the AIFA website. To investigate people’s attitudes toward possible access to the PPLs of vaccines and the acceptability of switching to an electronic package leaflet (e-leaflet) in the future, we surveyed three target groups (pregnant women, young parents, and older people) in Italy, via an online survey. We collected 321 questionnaires from the cohorts, which comprised 104 pregnant women, 105 young parents, and 112 older people. The results indicate in all target groups that health care professionals (HCPs) do not usually offer the vaccine PPL during the vaccination session: only about 10.7% of respondents receive the PPL without asking for it, with pregnant women receiving it the most frequently. The acceptance rate for switching from a PPL to an e-leaflet is fairly high in all target groups (76.9% in pregnant women, 81.9% in young parents, and 66.1% in the elderly), especially if the option exists to request a paper print, to make sure that people with a low level of digital skills can access the PPL information as well. HCPs have an important role in ensuring access to the PPLs of vaccines. HCPs should be trained to inform their patients about the different options for accessing the PPLs (as well as online access) to increase their patients’ knowledge and satisfaction.
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Affiliation(s)
- Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (M.D.T.); (N.S.); (P.B.); (S.B.)
- Correspondence: ; Tel.: +39-055-275-1081
| | - Fabrizio Chiesi
- Central Tuscany Local Health Unit (ASL Toscana-Centro), 50122 Florence, Italy; (F.C.); (E.A.); (P.P.); (G.M.); (M.G.M.)
| | | | - Eleonora Gori
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy;
| | - Mariarosaria Di Tommaso
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (M.D.T.); (N.S.); (P.B.); (S.B.)
| | - Noemi Strambi
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (M.D.T.); (N.S.); (P.B.); (S.B.)
| | - Elisabetta Alti
- Central Tuscany Local Health Unit (ASL Toscana-Centro), 50122 Florence, Italy; (F.C.); (E.A.); (P.P.); (G.M.); (M.G.M.)
| | - Paola Picciolli
- Central Tuscany Local Health Unit (ASL Toscana-Centro), 50122 Florence, Italy; (F.C.); (E.A.); (P.P.); (G.M.); (M.G.M.)
| | - Giovanna Mereu
- Central Tuscany Local Health Unit (ASL Toscana-Centro), 50122 Florence, Italy; (F.C.); (E.A.); (P.P.); (G.M.); (M.G.M.)
| | - Maria Grazia Mori
- Central Tuscany Local Health Unit (ASL Toscana-Centro), 50122 Florence, Italy; (F.C.); (E.A.); (P.P.); (G.M.); (M.G.M.)
| | | | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, 2000 Antwerp, Belgium; (P.V.D.); (M.B.)
| | - Martina Bamberger
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, 2000 Antwerp, Belgium; (P.V.D.); (M.B.)
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (M.D.T.); (N.S.); (P.B.); (S.B.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (M.D.T.); (N.S.); (P.B.); (S.B.)
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Regulation of Drug Prescribing Information in Latin America and the Caribbean. Ther Innov Regul Sci 2022; 56:536-551. [PMID: 35380375 PMCID: PMC9135787 DOI: 10.1007/s43441-022-00396-y] [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: 12/03/2021] [Accepted: 03/14/2022] [Indexed: 11/08/2022]
Abstract
Objective To describe the status of drug regulations in Latin America and the Caribbean, in force as of May 2021, and assess through a comparative exercise the differences between the countries under scope on prescribing information of drugs for human use. Materials and Methods A narrative review allowed the identification of the regulations concerning the prescribing information of drugs in 25 countries in Latin America and the Caribbean for the registration of prescription medications. On this basis, terms and concepts regarding this topic, the general provisions by the regulatory authorities for these products, applications for health registration and further amendments were identified for each country. Results The Latin American and the Caribbean countries included, manage and regulate drug prescribing information differently in terms of concepts, information publishing, structure for product information, among other criteria. Few health authorities publish product information on their website. Additionally, the patient information leaflet is not requested for prescription drugs in most of the studied countries. There is no standardized structure for drug product information within the region. Conclusions A poor level of harmonization among the regulations from these countries regarding the content and management (e.g. if physical package insert is required or not, if it is subject to notification or approval) of the prescribing information of human use drugs became evident. Also, there is a visible lack of standardization of concepts for referring to a specific document (e.g., package insert for healthcare professionals, patient information leaflet and technical information for the drug product) and in the content itself.
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Noble AJ, Haddad S, Coleman N, Marson AG. Worth the paper they're printed on? Findings from an independent evaluation of how understandable patient information leaflets for antiseizure medications are. Epilepsia 2022; 63:2130-2143. [PMID: 35560228 PMCID: PMC9544238 DOI: 10.1111/epi.17299] [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: 03/16/2022] [Revised: 04/21/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The Patient Information Leaflet (PIL) is an authoritative document that all people with epilepsy (PWE) in the European Union receive when prescribed anti-seizure medication (ASM). We undertook the first independent, comprehensive assessment to determine how understandable they are. Regulators state that when patients are asked comprehension questions about them, ≥80% should answer correctly. Also recommended PILs have a maximum reading requirement of US Grade 8. METHODS Study 1: Obtained 140 current ASM PILs written in English. 'Readability' assessed using 4 tests, with and without adjustment for influence of familiar, polysyllabic words. 179 online materials on epilepsy also assessed. Study 2: Two PILs from Study 1 randomly selected (Pregabalin Focus; Inovelon) and shown to 35 people from UK epilepsy population. Their comprehension was assessed. Study 3: To understand whether student population provides accessible alternative population for future examination of ASM PILs, Study 3 was completed. Used same methods as Study 2 but participants were 262 UK university students. RESULTS Study 1: No PIL had a reading level of Grade 8. Median was 11. Adjusting for context, the PILs were still at Grade 10.5. PILs for branded ASMs were most readable. PILs were no more readable than (unregulated) online materials. Study 2: Users struggled to comprehend the PILs key messages. The 8 questions asked about pregabalin were typically answered correctly by 54%. For Inovelon it was 62%. Study 3: Most student participants comprehend the PILs key messages. The questions about Inovelon were answered correctly by 90%; for pregabalin it was 86%. SIGNIFICANCE This is the first independent and comprehensive examination of ASM PILs. Found PILs being used fail to meet recommendations and regulatory requirements and risk not being understandable to substantial proportion of users. In finding that people from epilepsy population differ markedly in comprehension of PILs compared to students, study highlights importance of completing user testing with the target population.
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Affiliation(s)
- Adam J Noble
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Sarah Haddad
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Niamh Coleman
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Anthony G Marson
- Department of Pharmacology and Therapeutics, University of Liverpool., UK
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Olchowska-Kotala A, Uchmanowicz I, Szczepanowski R. Verbal Descriptors of the Frequency of Side Effects: Implementation of EMA Recommendations in Patient Information Leaflets in Poland. Int J Qual Health Care 2022; 34:6547612. [DOI: 10.1093/intqhc/mzac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/20/2021] [Accepted: 03/11/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The European Medicines Agency (EMA) recommends a description of drug side effects based on the frequency format and the associated verbal description. Although the recommendations refer to English-speaking countries, in several non-English speaking states, official authorities have accepted the proposed recommendations on how the patient information leaflets should be designed for descriptions of side effect frequencies. The aim of the study was to examine how manufacturers of authorized medicines in Poland implement the EMA recommendations regarding the verbal descriptors of the frequency of side effects.
Methods
A qualitative study. As a first step, we identified which of the 150 pharmaceutical companies operating in Poland had the largest market share. Then, five manufacturers were selected at random from the list of the top fifteen drug manufacturers in Poland by market share of the pharmaceutical sector. Lists of medicinal products authorized for marketing in Poland were downloaded from manufacturers’ websites, and then five products from each manufacturer were selected based on random sampling. The study included only prescription medicines and excluded over-the-counter medicines and dietary supplements from the sample. Subsequently, for each of the 25 drugs relevant patient information leaflets were obtained from the manufacturers’ websites. We evaluated how information on the frequency of side effects was provided in each leaflet, including the use of EU-recommended terms (verbal descriptors such as "very common," "common," "uncommon," "rare," "very rare") and additional notes explaining their meanings.
Results
For all manufacturers, word labels of the frequencies of side effects selected for the study were the same but the additional notes explaining their meanings were different. There were various explanations of how to understand verbal descriptors of the frequency of side effects not only across different manufacturers but also across different medicines from one manufacturer.
Conclusions
There is no single standard in the Polish pharmaceutical industry for implementing the EMA recommendations into the written information about the frequency of side effects. The observed differences for an explanation of how to understand a given verbal term do not favor a uniform interpretation of the verbal frequency labels meaning by patients.
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Affiliation(s)
- Agnieszka Olchowska-Kotala
- Department of Humanities and Social Science, Wroclaw Medical University, ul Mikulicza-Radeckiego 7, 50-368 Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, ul. K. Bartla 5, 51-618 Wroclaw, Poland
| | - Remigiusz Szczepanowski
- Department of Humanities and Social Science, Wroclaw Medical University, ul. K. Bartla 5, 51-618 Wroclaw, Poland
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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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Bamberger M, De Loof H, Marstboom C, Oury S, Bonanni P, Launay O, Kojouharova M, Van Damme P. Replacing vaccine paper package inserts: a multi-country questionnaire study on the acceptability of an electronic replacement in different target groups. BMC Public Health 2022; 22:156. [PMID: 35073891 PMCID: PMC8785016 DOI: 10.1186/s12889-022-12510-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/04/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In the European Union it is mandatory to include paper package leaflets (PPL) with all medicines, including vaccines, to inform the recipient. However, it is difficult to meet the necessity for localized PPLs in each of the 24 official European languages. Replacing PPLs with electronic versions offers many advantages including redistribution across nations, reduced storage space, accessibility by the visually impaired, easily updated information or the addition of video content. We wanted to assess the attitudes of patients (vaccine recipients or their parents) to the potential of replacing PPL with electronic versions.
Methods
We surveyed vaccinees or their parents in four European countries—Belgium, Italy, Bulgaria and France—for their actual use of vaccine PPLs and their opinions about switching to an electronic package leaflet. Our survey was conducted online because of the COVID-19 pandemic and resulted in 2518 responses to a questionnaire targeted at three specific groups with particular information needs: parents of young children, pregnant women and the elderly (≥ 60 years).
Results
Our main findings are that currently vaccine PPLs are rarely used and frequently unavailable for the vaccinee. Across the four countries surveyed 55–82% of vaccinees would accept an electronic version, as did 64% when there was an option to request a printout of the leaflet.
Conclusions
We found that switching to electronic versions of vaccine PPLs is an acceptable alternative for the public, potentially increasing the quality and amount of information reaching vaccinees while eliminating some barriers to redistribution of vaccines between countries.
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Smith LE, Sim J, Amlôt R, Cutts M, Dasch H, Sevdalis N, Rubin GJ, Sherman SM. Side-effect expectations from COVID-19 vaccination: Findings from a nationally representative cross-sectional survey (CoVAccS - wave 2). J Psychosom Res 2021; 152:110679. [PMID: 34823113 PMCID: PMC8595305 DOI: 10.1016/j.jpsychores.2021.110679] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Concern about side effects is one of the most common reasons for refusing vaccination. Side-effect expectations are known to predict perception of side effects. We aimed to investigate the percentage of people who thought side effects from COVID-19 vaccination were likely and investigate factors associated with side-effect expectation. METHODS Online cross-sectional survey of 1470 UK adults who had not been vaccinated for COVID-19 (conducted 13 to 15 January 2021). We asked participants how likely they thought side effects from COVID-19 vaccination were. Linear regression analyses were used to investigate associations with side-effect expectations. RESULTS Most participants were uncertain whether they would experience side effects from a COVID-19 vaccine; only a minority reported that side effects were very likely (9.4%, 95% CI 7.9% to 10.9%, n = 138/1470). Personal and clinical characteristics, general, and COVID-19 vaccination beliefs and attitudes explained 29.7% of the variance in side-effect expectation, with COVID-19 vaccination beliefs alone accounting for 17.2%. Side-effect expectations were associated with: older age, being clinically extremely vulnerable to COVID-19, being afraid of needles, lower perceived social norms for COVID-19 vaccination, lower perceived necessity and safety of COVID-19 vaccination, and perceived lack of information about COVID-19 and vaccination. CONCLUSIONS Side-effect expectation was associated with believing that COVID-19 vaccination was unsafe, ineffective and that others would be less likely to approve of you having a COVID-19 vaccination. Communications should emphasise the safety, effectiveness, and widespread uptake of vaccination, while promoting accurate perceptions of the incidence of vaccination side effects.
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Affiliation(s)
- Louise E Smith
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK.
| | - Julius Sim
- Keele University, School of Medicine, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK; UK Health Security Agency, Behavioural Science and Insights Unit, UK
| | | | - Hannah Dasch
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; King's College London, Centre for Implementation Science, UK
| | - Nick Sevdalis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; King's College London, Centre for Implementation Science, UK
| | - G James Rubin
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
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Outcomes and Critical Factors for Successful Implementation of Organizational Health Literacy Interventions: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211906. [PMID: 34831658 PMCID: PMC8622809 DOI: 10.3390/ijerph182211906] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/06/2021] [Accepted: 11/10/2021] [Indexed: 01/24/2023]
Abstract
Organizational health literacy (OHL)-interventions can reduce inequality and demands in health care encountered by patients. However, an overview of their impact and critical factors for organization-wide implementation is lacking. The aim of this scoping review is to summarize the evidence on: (1) the outcomes of OHL-interventions at patient, professional and organizational levels; and (2) the factors and strategies that affect implementation and outcomes of OHL-interventions. We reviewed empirical studies following the five-stage framework of Arksey and O'Malley. The databases Scopus, PubMed, PsychInfo and CINAHL were searched from 1 January 2010 to 31 December 2019, focusing on OHL-interventions using terms related to "health literacy", "health care organization" and "intervention characteristics". After a full-text review, we selected 24 descriptive stu-dies. Of these, 23 studies reported health literacy problems in relation to OHL-assessment tools. Nine out of thirteen studies reported that the use of interventions resulted in positive changes on OHL-domains regarding comprehensible communication, professionals' competencies and practices, and strategic organizational changes. Organization-wide OHL-interventions resulted in some improvement of patient outcomes but evidence was scarce. Critical factors for organization-wide implementation of OHL-interventions were leadership support, top-down and bottom-up approaches, a change champion, and staff commitment. Organization-wide interventions lead to more positive change on OHL-domains, but evidence regarding OHL-outcomes needs strengthening.
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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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Goyal R, Mercado AE, Ring D, Crijns TJ. Most YouTube Videos About Carpal Tunnel Syndrome Have the Potential to Reinforce Misconceptions. Clin Orthop Relat Res 2021; 479:2296-2302. [PMID: 33847604 PMCID: PMC8445577 DOI: 10.1097/corr.0000000000001773] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/12/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Studies of online health information have addressed completeness and adherence to evidence, which can be difficult because current evidence leaves room for debate about etiology, diagnosis, and treatment. Fewer studies have evaluated whether online health information can reinforce misconceptions. It can be argued that information with the potential to harm health by reinforcing unhelpful misconceptions ought to be held to a higher standard of evidence. QUESTIONS/PURPOSES (1) What is the prevalence and nature of health information in YouTube videos with the potential to reinforce common misconceptions about symptoms and treatment associated with carpal tunnel syndrome (CTS)? (2) What factors (such as the number of views, likes, and subscribers) are associated with Potential Reinforcement of Misconception scores of YouTube videos about CTS? METHODS After removing all personalized data, we searched for the term "carpal tunnel syndrome" on YouTube, reviewed the first 60 English-language videos that discussed the diagnosis and treatment of CTS, and collected available metrics. The primary outcome was the number of statements that could reinforce misconceptions about CTS, rated by two authors using a checklist. As a secondary outcome, we counted the number of statements that could help patients by reorienting or balancing common misconceptions, providing agency, and facilitating decisions, and we subtracted the number of potential misconceptions from this count. A modified version of the DISCERN instrument (a validated scoring system designed to gauge the quality and reliability of health information) was used to evaluate each video. We sought factors associated with the Potential Reinforcement of Misconception score-in both the negative-only and combined (positive and negative) variations-accounting for various YouTube metrics (such as the number of views, number of likes and dislikes, and duration) and the modified DISCERN score. The interrater reliability was excellent for both the Potential Reinforcement of Misconceptions checklist (ICC = 0.97; Pearson correlation [r] = 0.97) and DISCERN information quality score (ICC = 0.96; r = 0.97). RESULTS Seventy-eight percent of the YouTube videos (47 of 60 videos) contained at least one statement that could reinforce common misconceptions about CTS. The median number of potentially misconception-reinforcing statements was two (range one to three), with the most common statements being that CTS is caused by hand use (38%; 23 of 60 videos) and that splints can alter the natural history of the disease (37%; 22 videos). Videos that were more popular (higher number of views or likes) did not contain less potential reinforcement of misconceptions. In the multivariable analysis, we found a strong association between the DISCERN score and the CTS Potential Reinforcement of Misconceptions score (regression coefficient = 0.67; 95% CI 0.22-1.2; partial r2 = 0.13; p = 0.004) and a lower number of subscribers (calculated per one million subscribers: regression coefficient = -0.91; 95% CI -1.8 to -0.023; p = 0.045). CONCLUSION Potential reinforcement of misconceptions is prevalent in YouTube videos about CTS, more so in videos with lower information quality scores. CLINICAL RELEVANCE Online health information should be held to a standard of accuracy (alignment with best evidence), and where such evidence leaves room for debate, it should be held to a standard by which unhealthy misconceptions are not reinforced.
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Affiliation(s)
- Ria Goyal
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Amelia E. Mercado
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Tom J. Crijns
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
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Para A, Thelmo F, Rynecki ND, Zelman B, Gupta R, Coban D, Ayyaswami V, Prabhu AV, Ippolito JA, Agarwal N, Moore JM, Beebe KS. Evaluating the Readability of Online Patient Education Materials Related to Orthopedic Oncology. Orthopedics 2021; 44:38-42. [PMID: 33141234 DOI: 10.3928/01477447-20201012-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/20/2020] [Indexed: 02/03/2023]
Abstract
The internet is increasingly used to access patient education materials. The average American reading level has been found to be that of a 7th- to 8th-grade student, prompting the National Institutes of Health (NIH) and the American Medical Association (AMA) to advise that patient education materials be written between the 4th- to 6th-grade reading level. The purpose of this study was to evaluate the reading level of current patient education materials for the most common musculoskeletal oncological tumors. A Google search was performed with all location filters off to account for geographic variability for patient education materials related to 28 orthopedic primary or secondary tumors. All patient education articles from the first 10 website hits for each tumor type were analyzed. Patient education materials from these websites were evaluated using 8 validated readability scales. Patient resources were found to be written at an average grade level nearly double the NIH and AMA recommendation. Patient education materials for soft tissue chondromas were written at the highest level (14.8±1.9), whereas education materials for chordomas (10.1±1.0) most closely approached national recommendations, despite still being written at a readability level nearly 4 grade levels higher than has been recommended. The Flesch Reading Ease assessment provided a mean score of 46.5±7.7, corresponding with a "difficult to read" result. Current patient education materials regarding oncological musculoskeletal-related patient education materials are written significantly above the recommended reading level. Further modification of these resources is warranted to ensure adequate comprehension and informed decision making in the clinical setting. [Orthopedics. 2021;44(1):38-42.].
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Świeczkowski D, Kułacz S. The use of the Gunning Fog Index to evaluate the readability of Polish and English drug leaflets in the context of Health Literacy challenges in Medical Linguistics: An exploratory study. Cardiol J 2020; 28:627-631. [PMID: 33140389 DOI: 10.5603/cj.a2020.0142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 11/25/2022] Open
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Smith LE, Webster RK, Rubin GJ. A systematic review of factors associated with side-effect expectations from medical interventions. Health Expect 2020; 23:731-758. [PMID: 32282119 PMCID: PMC7495066 DOI: 10.1111/hex.13059] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Fear of side-effects can result in non-adherence to medical interventions, such as medication and chemotherapy. Side-effect expectations have been identified as strong predictors of later perception of side-effects. However, research investigating predictors of side-effect expectations is disparate. OBJECTIVE To identify factors associated with side-effect expectations. SEARCH STRATEGY We systematically searched Embase, Ovid MEDLINE, Global Health, PsycARTICLES, PsycINFO, Web of Science and Scopus. INCLUSION CRITERIA Studies were included if they investigated associations between any predictive factor and expectations of side-effects from any medical intervention. DATA EXTRACTION AND SYNTHESIS We extracted information about participant characteristics, medication, rates of side-effects expected and predictors of side-effect expectations. Data were narratively synthesized. MAIN RESULTS We identified sixty-four citations, reporting on seventy-two studies. Predictors fell into five categories: personal characteristics, clinical characteristics, psychological traits and state, presentation format of information, and information sources used. Using verbal risk descriptors (eg 'common') compared to numerical descriptors (eg percentages), having lower quality of life or well-being, and currently experiencing symptoms were associated with increased side-effect expectations. DISCUSSION AND CONCLUSIONS Decreasing unrealistic side-effect expectations may lead to decreased experience of side-effects and increased adherence to medical interventions. Widespread communications about medical interventions should describe the incidence of side-effects numerically. Evidence suggests that clinicians should take particular care with patients with lower quality of life, who are currently experiencing symptoms and who have previously experienced symptoms from treatment. Further research should investigate different clinical populations and aim to quantify the impact of the media and social media on side-effect expectations.
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Affiliation(s)
- Louise E Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - G James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Chapman E, Haby MM, Toma TS, de Bortoli MC, Illanes E, Oliveros MJ, Barreto JOM. Knowledge translation strategies for dissemination with a focus on healthcare recipients: an overview of systematic reviews. Implement Sci 2020; 15:14. [PMID: 32131861 PMCID: PMC7057470 DOI: 10.1186/s13012-020-0974-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 02/17/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND While there is an ample literature on the evaluation of knowledge translation interventions aimed at healthcare providers, managers, and policy-makers, there has been less focus on patients and their informal caregivers. Further, no overview of the literature on dissemination strategies aimed at healthcare users and their caregivers has been conducted. The overview has two specific research questions: (1) to determine the most effective strategies that have been used to disseminate knowledge to healthcare recipients, and (2) to determine the barriers (and facilitators) to dissemination of knowledge to this group. METHODS This overview used systematic review methods and was conducted according to a pre-defined protocol. A comprehensive search of ten databases and five websites was conducted. Both published and unpublished reviews in English, Spanish, or Portuguese were included. A methodological quality assessment was conducted; low-quality reviews were excluded. A narrative synthesis was undertaken, informed by a matrix of strategy by outcome measure. The Health System Evidence taxonomy for "consumer targeted strategies" was used to separate strategies into one of six categories. RESULTS We identified 44 systematic reviews that describe the effective strategies to disseminate health knowledge to the public, patients, and caregivers. Some of these reviews also describe the most important barriers to the uptake of these effective strategies. When analyzing those strategies with the greatest potential to achieve behavioral changes, the majority of strategies with sufficient evidence of effectiveness were combined, frequent, and/or intense over time. Further, strategies focused on the patient, with tailored interventions, and those that seek to acquire skills and competencies were more effective in achieving these changes. In relation to barriers and facilitators, while the lack of health literacy or e-literacy could increase inequities, the benefits of social media were also emphasized, for example by widening access to health information for ethnic minorities and lower socioeconomic groups. CONCLUSIONS Those interventions that have been shown to be effective in improving knowledge uptake or health behaviors should be implemented in practice, programs, and policies-if not already implemented. When implementing strategies, decision-makers should consider the barriers and facilitators identified by this overview to ensure maximum effectiveness. PROTOCOL REGISTRATION PROSPERO: CRD42018093245.
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Affiliation(s)
| | - Michelle M. Haby
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora Mexico
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC Australia
| | - Tereza Setsuko Toma
- Instituto de Saúde, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil
| | | | | | - Maria Jose Oliveros
- Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
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Jarernsiripornkul N, Nakboon S, Anarj K, Wongtaweepkij K. Survey of healthcare professionals' practices, expectations, and attitudes towards provision of patient information leaflets in Thailand. Int J Clin Pharm 2020; 42:539-548. [PMID: 31955382 DOI: 10.1007/s11096-020-00965-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 01/07/2020] [Indexed: 11/30/2022]
Abstract
Background Patient information leaflets are an important source of medicine information for patients. In Thailand, there is a lack of studies exploring activities of healthcare professionals and their attitudes towards provision of patient information leaflets. Objectives This study aimed to survey healthcare professionals' practices on provision of medicine information, expectations of, attitudes towards provision of patient information leaflets and factors influencing these. Setting Two university hospitals in Thailand. Methods A self-completion questionnaire was distributed to chiefs of departments for further distribution to staff. A stratified sample of physicians and nurses was invited, while all pharmacists were invited to ensure sufficient numbers for comparison. Main outcome measure Healthcare professionals' practices on provision of medicine information, expectations of, attitudes towards provision of patient information leaflets. Results Of the total 981 healthcare professionals invited, 493 responded (50.3% response rate). The number of respondents aware of patient information leaflets was 270 (57.6%). Of these, only 44.4% had ever given patient information leaflets to patients. Pharmacists provided patient information leaflets more frequently than other healthcare professionals. The expectation for patient information leaflets to be available was high; mean score 7.9 ± 2.31 of possible 10. Most respondents had positive attitudes towards providing patient information leaflets to patients (58.2%). Respondents who were aware of patient information leaflets availability were more likely to have a positive attitude (OR 0.543, p = 0.002). Level of education, time spent in direct care and being aware of patient information leaflets were factors associated with healthcare professionals' attitudes. Conclusion Limited number of healthcare professionals had provided patient information leaflets to patients but most had positive attitudes regarding the usefulness of patient information leaflets for patients. Increased availability and use of patient information leaflets should be promoted.
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Affiliation(s)
- Narumol Jarernsiripornkul
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand.
| | - Sireerat Nakboon
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Kobkaew Anarj
- Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Kamonphat Wongtaweepkij
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok, Thailand
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Kaper M, Sixsmith J, Meijering L, Vervoordeldonk J, Doyle P, Barry MM, de Winter AF, Reijneveld SA. Implementation and Long-Term Outcomes of Organisational Health Literacy Interventions in Ireland and The Netherlands: A Longitudinal Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234812. [PMID: 31795504 PMCID: PMC6926611 DOI: 10.3390/ijerph16234812] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/14/2019] [Accepted: 11/26/2019] [Indexed: 11/16/2022]
Abstract
Organisational Health Literacy (OHL)-interventions are needed to overcome health inequality. OHL-interventions have successfully identified communication barriers at the organisational level, but evidence is limited on the extent to which this leads to sustainable organisational change. This study aims to assess the implementation fidelity, moderators (barriers and facilitators), and long-term impact of OHL-interventions in hospitals in Ireland and The Netherlands. We used a longitudinal mixed-methods approach to assess two similar OHL-interventions in one Irish and three Dutch hospitals. The OHL-interventions concerned the improvement of navigation and implementation of health literacy-friendly communication throughout organisations. Participants were 24 hospital employees and 40 older adults who use hospital services. At six, eight, and eighteen months, we assessed the level of implementation, barriers and facilitators, and impact through questionnaires and in-depth semi-structured interviews. After older adults and professionals had identified a number of communication problems, we found that professionals had successfully implemented OHL-interventions to promote navigation and comprehensible communication. Limited resources and variation in organisational structures and procedures were perceived as barriers to implementation. The participation of service users, leadership support, and a stepwise implementation of interventions were perceived to facilitate implementation. In the long term, the OHL-interventions led to system-wide improvements, as shown by better embedding of health literacy policies, enhanced patient engagement, provision of plain language training and comprehensible information. Findings were similar for the two countries. Embedded OHL-interventions resulted in sustainable and system-wide health literacy changes in all four hospitals. Following implementation, OHL-interventions have the potential to promote health equity and empowerment among health service users.
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Affiliation(s)
- Marise Kaper
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Correspondence:
| | - Jane Sixsmith
- Health Promotion Research Centre, National University of Ireland Galway, University Road, H91 TK33 Galway, Ireland; (J.S.); (P.D.); (M.M.B.)
| | - Louise Meijering
- Population Research Center, Urban and Regional Studies Institute, University of Groningen, Landleven 1, P.O. Box 800, 9700 AV Groningen, The Netherlands;
| | - Janine Vervoordeldonk
- Health Impact Gezondheid & Zorg, Blinkertlaan 7, Dishoek, 4371 PV Veere, The Netherlands;
| | - Priscilla Doyle
- Health Promotion Research Centre, National University of Ireland Galway, University Road, H91 TK33 Galway, Ireland; (J.S.); (P.D.); (M.M.B.)
| | - Margaret M. Barry
- Health Promotion Research Centre, National University of Ireland Galway, University Road, H91 TK33 Galway, Ireland; (J.S.); (P.D.); (M.M.B.)
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
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Vaillancourt R, Giby CN, Murphy BP, Pouliot A, Trinneer A. Recall of Pharmaceutical Pictograms by Older Adults. Can J Hosp Pharm 2019; 72:446-454. [PMID: 31853145 PMCID: PMC6910848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Low health literacy and high medication burden in the older adult population are contributing factors to the misunderstanding of medication instructions, leading to an increased risk of poor adherence and adverse events in this group of patients. OBJECTIVE To evaluate the ability of older adults to recall the meaning of 13 pharmaceutical pictograms 4 weeks after receipt of feedback on pictogram meaning. METHODS Older adults (aged 65 or older) were recruited from one community pharmacy in Canada. One-on-one structured interviews were conducted to assess the comprehensibility of 13 pharmaceutical pictograms from the International Pharmaceutical Federation's database of pictograms. Each participant was then told the meaning of each pictogram. Recall was assessed 4 weeks later. RESULTS A total of 58 participants met the inclusion criteria and agreed to participate. The number of pictograms meeting the ISO threshold for comprehensibility of symbols increased from 10 at the initial comprehensibility assessment to 13 at the recall assessment. Analysis of demographic data showed no associations between initial comprehensibility of the pictograms and age, sex, education level, or number of medications taken. CONCLUSIONS The results of this study indicate that after being informed of the meaning of pharmaceutical pictograms, older adults were able to recall the pictogram meanings for at least 4 weeks.
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Affiliation(s)
- Régis Vaillancourt
- , OMM, CD, BPharm, PharmD, FCSHP, is with the Department of Pharmacy, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Cindy N Giby
- , PharmD, is with Shoppers Drug Mart, Ottawa, Ontario
| | - Bradley P Murphy
- , BSc, PharmD, was, at the time this study was conducted, a student at the University of Waterloo, School of Pharmacy. He is now with the Department of Pharmacy, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Annie Pouliot
- , PhD, was, at the time this study was conducted, with the Department of Pharmacy, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Anne Trinneer
- , MA, is with the Department of Pharmacy, Children's Hospital of Eastern Ontario, Ottawa, Ontario
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Pires C, Rosa PJ, Vigário M, Cavaco A. Validation of a new tool for evaluating subjects' satisfaction with medicine package leaflets: a cross-sectional descriptive study. SAO PAULO MED J 2019; 137:454-462. [PMID: 31939571 PMCID: PMC9745827 DOI: 10.1590/1516-3180.2019.0123160919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/16/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Package leaflets of medicines need to be intelligible, but tools for their evaluation are scarce. OBJECTIVE To validate a new tool for assessing subjects' satisfaction with medicine package leaflets (LiS-RPL). DESIGN AND SETTING Cross-sectional descriptive study conducted in two regions of Portugal (Lisbon and Centre). METHODS 503 participants (53.1% male) were selected according to convenience and homogenously distributed into three groups: 1 to 6; 7 to 12; and > 12 years of schooling. LiS-RPL was developed based on international regulation guidelines and was initially composed of 14 items. Twelve package leaflets were tested. Dimensionality calculations included: exploratory factor analysis and minimum rank factor analysis; Kaiser-Meyer-Olkin index and Bartlett's sphericity test to assess matrix adequacy for exploratory factor analysis; exploratory bifactor analysis with Schmid-Leiman solution to detect possible existence of a broad second-order factor; and Bentler's Simplicity Index and Loading Simplicity Index to assess factor simplicity. Diverse coefficients were calculated to assess reliability. RESULTS Minimum rank factor analysis detected a two-factor or single-factor structure. Exploratory factor analysis with 12 items showed a two-factor structure, explaining 69.11% of the variance. These items were strongly correlated with each other (r = 0.80). Schmid-Leiman: all items seemed to represent the general factor (loadings above 0.50), which was 76.4% of the extracted variance. Simplicity indices were good (percentile 99): Bentler's Simplicity Index of 0.99 and Loading Simplicity Index of 0.48. Internal consistency indexes indicated good reliability. LiS-RPL was shown to be homogenous. CONCLUSION LiS-RPL is a validated tool for evaluating subjects' satisfaction with medicine package leaflets.
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Affiliation(s)
- Carla Pires
- PhD. Pharmacist and Invited Professor, Department of Pharmacotherapy, Research Center for Biosciences and Health Technologies (CBIOS), Universidade Lusófona, Campo Grande, Lisbon, Portugal.
| | - Pedro Joel Rosa
- PhD. Psychologist, Statistician and Assistant Professor, Psychology Department, School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies (ULHT), Lisbon, Portugal; Human Environment Interaction Lab (HEI-lab), ULHT, Lisbon, Portugal; Instituto Universitário de Lisboa (ISCTE-IUL), Cis-IUL, Lisbon, Portugal.
| | - Marina Vigário
- PhD. Linguist and Associate Professor, Department of General and Romance Linguistics, School of Arts and Humanities & Centre of Linguistics, University of Lisbon, Lisbon, Portugal.
| | - Afonso Cavaco
- PhD. Pharmacist and Associate Professor, Department of Social Pharmacy, School of Pharmacy, Research Institute for Medicines and Pharmaceutical Sciences, University of Lisbon, Lisbon, Portugal.
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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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Panich J, Gooden A, Shirazi FM, Malone DC. Warnings for drug-drug interactions in consumer medication information provided by community pharmacies. J Am Pharm Assoc (2003) 2018; 59:35-42. [PMID: 30416068 DOI: 10.1016/j.japh.2018.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In 2006, the U.S. Food and Drug Administration (FDA) issued a draft guidance for pharmacies to provide consumer medication information (CMI) to patients receiving prescription medications. The objective of this study was to evaluate CMI leaflets provided by community pharmacies for accuracy and completeness regarding drug-drug interactions (DDIs). METHODS CMI leaflets were obtained for 3 commonly prescribed medications (azithromycin, ciprofloxacin, and simvastatin) from 14 community pharmacies that are part of 6 chain organizations that operate in southern Arizona. Three to 4 salient interacting medications for each leaflet medication were identified with the use of 2 well recognized drug compendia. The content of the DDI information in the leaflets was evaluated for completeness. The font size and reading level of each leaflet were assessed as well. RESULTS The CMI provided by 14 pharmacies appeared to be produced by 2 information vendors, Wolters Kluwer and First Databank. This was evident based on the identical wording and attribution (e.g., copyright statements) on the leaflets. The CMI from First Databank mentioned 5 of the 11 previously identified interactions with the target medications, although 1 chain in this group chose not to print the DDI section at all and as a result scored 0. The CMI developed by Wolters Kluwer mentioned only 2 of the 11 identified DDIs. The average reading grade level for First Databank leaflets was 10.6 (SD 2.87), and the reading level for the CMI from Wolters Kluwer was 5.0 (SD 1.02). The font sizes varied from 8 to 12 points; FDA recommends that the information be printed in 12-point size or larger. CONCLUSION Community pharmacies appear to be distributing CMI leaflets with limited warnings about serious and well known DDIs. The results of this study suggest that consumers are not being informed through the CMI about important known DDIs.
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Basch CH, Fera J, Ethan D, Garcia P, Perin D, Basch CE. Readability of online material related to skin cancer. Public Health 2018; 163:137-140. [PMID: 30149263 DOI: 10.1016/j.puhe.2018.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/31/2018] [Accepted: 07/10/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The key to reducing mortality from skin cancer depends on early detection and treatment, which, in many cases, means a patient should be informed and possess the self-efficacy necessary to seek expert opinion. The purpose of this study was to determine the readability of skin cancer materials on the Internet using the commonly used readability tests. STUDY DESIGN This is a cross-sectional study. METHODS A search was conducted using the key words 'skin cancer.' The first 15 pages of websites that contained English language articles on skin cancer comprised the sample for this study. All English language articles appearing on these websites were analyzed using the Readable.io service to automate popular readability scores. For each article, it was determined if it was generated from a .org, .com, .gov, .net, .edu or other source. Five readability tests were conducted on the materials to determine the ease with which one can read each article. RESULTS Of the 102 websites sampled, none received an acceptable score on all five assessments. In fact, more than 90% of the websites sampled received an unacceptable score on any one of the five assessments, and more than 78% of the websites sampled received an unacceptable level on all five assessments. All five readability assessments demonstrated statistically significant results; each P-value obtained from the t-tests was substantially below 0.01 and, hence, below the α = 0.05 threshold. These results indicate that it is unlikely that skin cancer websites are being written at the recommended level. Of the websites sampled, roughly 42% were .com, and slightly more than 36% were .org. Statistical evidence indicated that neither .com nor .org websites are likely to be written at the acceptable level. CONCLUSIONS Both for-profit and non-profit agencies which aim to provide health information to consumers should be mindful of the readability levels of the materials they disperse.
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Affiliation(s)
- C H Basch
- Department of Public Health, William Paterson University, Wayne, NJ 07470, USA.
| | - J Fera
- Department of Mathematics, Lehman College, The City University of New York, USA
| | - D Ethan
- Health Education and Promotion, Department of Health Sciences, Lehman College, The City University of New York, USA
| | - P Garcia
- Department of Public Health, William Paterson University, Wayne, NJ 07470, USA
| | - D Perin
- Department of Health and Behavior Studies, Teachers College, Columbia University, NY, NY 10027, USA
| | - C E Basch
- Department of Health and Behavior Studies, Teachers College, Columbia University, NY, NY 10027, USA
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Hedenrud T, Andersson Sundell K, Martinsson J, Håkonsen H. Attitudes towards sales and use of over-the-counter drugs in Sweden in a reregulated pharmacy market: a population-based study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2018; 27:17-24. [PMID: 29687513 DOI: 10.1111/ijpp.12457] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 03/22/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To analyse attitudes towards sales and use of over-the-counter (OTC) drugs in the Swedish adult population. METHODS Data were collected through the web-based Citizen Panel comprising 21 000 Swedes. A stratified sample of 4058 participants was emailed a survey invitation. Questions concerned use of OTC drugs, and attitudes towards sales and use of OTC drugs. Correlations between the attitudinal statements were assessed using Spearman's rank correlation. Associations between attitudes and participant characteristics were analysed using multinomial logistic regression. KEY FINDINGS Participation rate was 64%. Altogether 87% reported use of OTC drugs in the last 6 months. Approximately 10% of participants stated that they used OTC drugs at the first sign of illness, and 9% stated that they used more OTC drugs compared with previously, due to increased availability. The statement on use of OTC drugs at first sign of illness correlated with the statement about using more OTC drugs with increased availability. Socio-demographic factors (age, sex and education) and frequent use of OTC drugs were associated with attitudes to sales and use of OTC drugs. CONCLUSIONS Increased use due to greater availability, in combination with OTC drug use at first sign of illness illustrates the need for continuous education of the population about self-care with OTC drugs. Increased awareness of the incautious views on OTC drugs in part of the population is important. Swedish policy-makers may use such knowledge in their continuous evaluation of the 2009 pharmacy reform to review the impact of sales of OTC drugs in retail outlets on patient safety and public health. Pharmacy and healthcare staff could be more proactive in asking customers and patients about their use of OTC drugs and offering them advice.
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Affiliation(s)
- Tove Hedenrud
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Johan Martinsson
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Helle Håkonsen
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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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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Smith KG, Booth JL, Stewart D, Pfleger S, Mciver L, Maclure K. Supporting shared decision-making and people's understanding of medicines: An exploration of the acceptability and comprehensibility of patient information. Pharm Pract (Granada) 2017; 15:1082. [PMID: 29317925 PMCID: PMC5742002 DOI: 10.18549/pharmpract.2017.04.1082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/15/2017] [Indexed: 11/14/2022] Open
Abstract
Background Patient information may assist in promoting shared decision-making, however it is imperative that the information presented is comprehensible and acceptable to the target audience. Objective This study sought to explore the acceptability and comprehensibility of the ' Medicines in Scotland: What's the right treatment for you?' factsheet to the general public. Methods Qualitative semi-structured telephone interviews were conducted with members of the public. An interview schedule was developed to explore the acceptability and comprehensibility of the factsheet. Participants were recruited by a researcher who distributed information packs to attendees (n=70) of four community pharmacies. Interviews, (12-24 minutes duration), were audio recorded, transcribed verbatim and analysed using a framework approach. Results Nineteen participants returned a consent form (27.1%), twelve were interviewed. Six themes were identified: formatting of the factsheet and interpretation; prior health knowledge and the factsheet; information contained in the factsheet; impact of the factsheet on behaviour; uses for the factsheet; and revisions to the factsheet. Conclusions The factsheet was generally perceived as helpful and comprehensive. It was highlighted that reading the leaflet may generate new knowledge and may have a positive impact on behaviour.
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Affiliation(s)
- Katie Gibson Smith
- School of Pharmacy and Life Sciences, Robert Gordon University. Aberdeen (United Kingdom).
| | - Jill L Booth
- Healthcare Improvement Scotland. Glasgow (United Kingdom).
| | - Derek Stewart
- School of Pharmacy and Life Sciences, Robert Gordon University. Aberdeen (United Kingdom).
| | - Sharon Pfleger
- Healthcare Improvement Scotland. Glasgow (United Kingdom).
| | - Laura Mciver
- Healthcare Improvement Scotland. Glasgow (United Kingdom).
| | - Kathrine Maclure
- School of Pharmacy and Life Sciences, Robert Gordon University. Aberdeen (United Kingdom).
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Segura-Bedmar I, Martínez P. Simplifying drug package leaflets written in Spanish by using word embedding. J Biomed Semantics 2017; 8:45. [PMID: 28962645 PMCID: PMC5622567 DOI: 10.1186/s13326-017-0156-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 09/19/2017] [Indexed: 11/10/2022] Open
Abstract
Background Drug Package Leaflets (DPLs) provide information for patients on how to safely use medicines. Pharmaceutical companies are responsible for producing these documents. However, several studies have shown that patients usually have problems in understanding sections describing posology (dosage quantity and prescription), contraindications and adverse drug reactions. An ultimate goal of this work is to provide an automatic approach that helps these companies to write drug package leaflets in an easy-to-understand language. Natural language processing has become a powerful tool for improving patient care and advancing medicine because it leads to automatically process the large amount of unstructured information needed for patient care. However, to the best of our knowledge, no research has been done on the automatic simplification of drug package leaflets. In a previous work, we proposed to use domain terminological resources for gathering a set of synonyms for a given target term. A potential drawback of this approach is that it depends heavily on the existence of dictionaries, however these are not always available for any domain and language or if they exist, their coverage is very scarce. To overcome this limitation, we propose the use of word embeddings to identify the simplest synonym for a given term. Word embedding models represent each word in a corpus with a vector in a semantic space. Our approach is based on assumption that synonyms should have close vectors because they occur in similar contexts. Results In our evaluation, we used the corpus EasyDPL (Easy Drug Package Leaflets), a collection of 306 leaflets written in Spanish and manually annotated with 1400 adverse drug effects and their simplest synonyms. We focus on leaflets written in Spanish because it is the second most widely spoken language on the world, but as for the existence of terminological resources, the Spanish language is usually less prolific than the English language. Our experiments show an accuracy of 38.5% using word embeddings. Conclusions This work provides a promising approach to simplify DPLs without using terminological resources or parallel corpora. Moreover, it could be easily adapted to different domains and languages. However, more research efforts are needed to improve our approach based on word embedding because it does not overcome our previous work using dictionaries yet.
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Affiliation(s)
- Isabel Segura-Bedmar
- Computer Science Departament, Universidad Carlos III de Madrid, Avenida de la Universidad, 30, Madrid, Spain.
| | - Paloma Martínez
- Computer Science Departament, Universidad Carlos III de Madrid, Avenida de la Universidad, 30, Madrid, Spain
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Fullmann K, Blackburn DF, Fenton ME, Mansell H. Readability and Suitability of COPD Consumer Information. Can Respir J 2017; 2017:2945282. [PMID: 28947874 PMCID: PMC5602649 DOI: 10.1155/2017/2945282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/12/2017] [Accepted: 07/25/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Information leaflets have been shown to positively or negatively impact adherence, depending on their content. The objective of this study was to perform an appraisal of the consumer information provided in COPD inhaler monographs. METHODS COPD inhalers were identified from the Health Canada Drug Product Database. Medication information and instructions for inhaler use were analyzed for readability by seven formulas, with an acceptability threshold of grades 6-8. Three researchers rated suitability using a modified Suitability Assessment of Materials (SAM) tool and assessed leaflets for explicit warnings. RESULTS Twenty-six inhalers with a COPD indication were evaluated. Medication information sections were rated as "difficult to read" or "hard," and 85% (22/26) had a reading level above grade 8. The instructions for inhaler use were rated as "easy" or "fairly easy" to read and 63% (16/26) met the threshold by all formulas. While all leaflets achieved superior suitability ratings, extreme warnings included risk of premature death (n = 12), risks of serious injury (n = 26), serious interactions (n = 26), and statements that convey a serious consequence to therapy (n = 26). CONCLUSION While COPD information leaflets in Canada performed well in terms of readability and suitability, overemphasis on side effects, warnings, and precautions may contribute to patient fear and nonadherence.
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Affiliation(s)
- Kathryn Fullmann
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - David F. Blackburn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Mark E. Fenton
- Division of Critical Care and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Holly Mansell
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
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Hedenrud T, Håkonsen H. Purchase habits, use of paracetamol, and information sources on a reregulated Swedish pharmacy market: A population-based study. Health Policy 2016; 121:35-41. [PMID: 27890394 DOI: 10.1016/j.healthpol.2016.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 11/11/2016] [Accepted: 11/13/2016] [Indexed: 10/20/2022]
Abstract
Considering the general lack of knowledge on how over-the-counter paracetamol is used combined with the reported increase in paracetamol poisonings after the reregulation of the Swedish pharmacy market in 2009, we aimed to analyze purchase habits and use of paracetamol in Sweden. A further aim was to investigate sources of information about paracetamol. Data were collected in October 2015 through the Citizen Panel, a Web-based panel encompassing over 50,000 Swedes. A stratified sample of 6000 (aged 18 years and older) was emailed a survey invitation. Questions concerned paracetamol use, purchase habits and information sources. The participation rate was 58%. A majority (70.5%) reported use of paracetamol during the last three months. Purchasing paracetamol solely over-the-counter was most common (81.1%). Close to two-thirds usually purchased paracetamol at a pharmacy. However, it was more common to purchase OTC paracetamol at non-pharmacy outlets among younger compared to older respondents. The results of this study did not reveal any harmful paracetamol use. The most common information source overall was patient information leaflets, and it was significantly more common among the youngest compared to older subjects. Based on our results combined with previous research, we suggest more studies, both qualitative and quantitative, among young adults, both on the use of paracetamol and on the understanding of information in patient information leaflets and on the Internet.
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Affiliation(s)
- T Hedenrud
- Department of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, P.O. Box 453, SE 405 30 Gothenburg, Sweden.
| | - H Håkonsen
- Department of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, P.O. Box 453, SE 405 30 Gothenburg, Sweden.
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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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36
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Pires C, Vigário M, Cavaco A. Factors influencing subjects' comprehension of a set of medicine package inserts. Int J Clin Pharm 2016; 38:888-98. [PMID: 27107582 DOI: 10.1007/s11096-016-0305-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
Background Package inserts (PIs) should promote the safe and effective use of medicines. The comprehension of PIs is related to socio-demographic features, such as education. Objectives To evaluate the participants' comprehension of a sample of PIs and to build an explanatory model of subjects' understanding of the content of these documents. Setting The data were collected from municipalities, city halls, firefighters, the military, schools and charities from two Portuguese regions. Methods Cross-sectional descriptive survey: 503 participants, homogeneously distributed by education and gender. The self-administered tool comprised questions on socio-demographic data, literacy tasks and comprehension evaluation of 12 purposively selected PIs. A logistic regression analysis was used. Main outcome measures Scores of numeracy tasks and comprehension. Results The average comprehension score for the PIs was 63 % (±32 %), with 48 % (n = 239) of the participants scoring <75 %. The most important predictors in explaining a comprehension score ≥75 % were having >12 years of education and correctly performing a numeracy task [respectively, OR 49.6 (CI 95 %: 22.8-108) and OR 2.48 (CI 95 %: 1.5-4.2)]. Conclusion An explanatory model of subjects' knowledge about the content of the tested PIs was built. Given that a high level of education and literacy were found to be the most relevant predictors for acceptable comprehension rates, PIs should be clearly written to assure that they are understood by all potential users, including the less educated. The evaluated PIs may thus need to be simplified.
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Affiliation(s)
- Carla Pires
- Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003, Lisbon, Portugal.
| | - Marina Vigário
- School of Arts and Humanities, University of Lisbon, Alameda da Universidade, 1600-214, Lisbon, Portugal
| | - Afonso Cavaco
- Research Institute for Medicines and Pharmaceutical Sciences, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003, Lisbon, Portugal
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