1
|
Wylde V, Brennan S, Johnson E, Roberts K, Beswick AD, Jameson C. Recommendations for developing accessible patient information leaflets for clinical trials to address English language literacy as a barrier to research participation. Trials 2024; 25:624. [PMID: 39334243 DOI: 10.1186/s13063-024-08471-5] [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: 06/13/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Low English language literacy is a common barrier to participation in clinical trials. Patient information leaflets (PILs) used in clinical trials are often lengthy, complex and have poor readability; this is a persistent and prevalent problem common to trials across the world. Simplifying the information provided in PILs can lead to improved understanding, comprehension and knowledge. The aim of this project was to develop recommendations for developing accessible PILs for clinical trials through a literature review of published and grey literature and co-working with marginalised communities, patients, and health and social care charities. METHODS A literature review of MEDLINE, Embase and online resources was conducted, and recommendations for developing accessible PILs were extracted from eligible published and grey literature. Grey literature which contained insights into more inclusive forms of communication was also identified and summarised. Meetings were held with two racially marginalised community groups, two groups involving autistic adults and/or adults with learning difficulties and a patient advisory group. Examples of accessible PILs were shared and discussions held about the content and format of the PILs and suggestions for changes/improvements. National Voices, a coalition of health and social care charities in England, held a national online workshop with charities and lived experience partners. Recommendations identified from the multiple sources were coded, collated and refined to develop an overarching framework of recommendations. RESULTS The framework consists of 74 recommendations for developing accessible PILs for clinical trials. Recommendations cover the five topics of formatting, information presentation, writing style, content and accessibility. CONCLUSIONS This project has developed a comprehensive framework of recommendations to guide researchers in the development of accessible PILs for clinical trials. Findings from previous research and from co-working with marginalised communities, patients and health and social care charities were collated to ensure that a diverse range of voices and experiences informed the framework. These recommendations aim to support researchers to develop better study information to reduce English language literacy as a barrier to participation in clinical trials.
Collapse
Affiliation(s)
- Vikki Wylde
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK.
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK.
| | | | - Emma Johnson
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kirsty Roberts
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Andrew D Beswick
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Catherine Jameson
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| |
Collapse
|
2
|
Kohut K, Morton K, Turner L, Foster R, Bancroft EK, Esplen MJ, Hanson H, Hurley K, Snape K, Eccles D, Foster C. 'I Live With Lynch. Cancer Worry Ebbs Into the Background, Then Something Brings It to the Fore.' A Qualitative Interview Study Exploring How Lynch Syndrome Carriers Make Sense of Their Cancer Risks and Implications to Support Decision Making. Psychooncology 2024; 33:e9312. [PMID: 39313415 DOI: 10.1002/pon.9312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 08/09/2024] [Accepted: 08/31/2024] [Indexed: 09/25/2024]
Abstract
BACKGROUND Lynch syndrome carriers ('carriers') are presented with complex, emotionally laden choices regarding management of increased genetic cancer risks. Decision aids encourage active involvement in values-based health decisions. This paper aimed to address the research question: How do Lynch syndrome carriers make sense of their chances of developing cancer, and what are the implications for providing support with decision making about genetic cancer risk management? METHODS Adult carriers were recruited through a genetics service or involvement with Lynch Syndrome UK. Semi-structured interviews explored lived experiences of carriers' access to care with a focus on decision support. Themes were constructed using framework analysis. These were developed into a conceptual model with recommendations for codevelopment of improved information and support including a tailored decision aid to complement integrated healthcare. RESULTS Twenty participants included 12 women and eight men, half with a history of cancer. Six overarching themes were: (1) finding balance with Lynch; (2) living 'on higher alert'; (3) managing uncertainty: 'I've thought about it a lot'; (4) burden of responsibility: 'It's on me'; (5) access to joined-up care and support: 'There's something missing'; and (6) influence/pressure from others. CONCLUSIONS This qualitative interview study provided in-depth insights from Lynch syndrome carriers about their lived experiences, informed by their values. Recommendations to empower carriers to make sense of genetic cancer risks and support decisions included accessible, trusted information, educated healthcare professionals, shared decision making, and joined-up integrated care pathways complemented by tailored decision aids.
Collapse
Affiliation(s)
- Kelly Kohut
- Centre for Psychosocial Research in Cancer: CentRIC, School of Health Sciences, University of Southampton, Southampton, UK
- South West Thames Centre for Genomics, Clinical Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Kate Morton
- Centre for Psychosocial Research in Cancer: CentRIC, School of Health Sciences, University of Southampton, Southampton, UK
| | - Lesley Turner
- Patient and Public Collaborator, University of Southampton, Southampton, UK
| | - Rebecca Foster
- Centre for Psychosocial Research in Cancer: CentRIC, School of Health Sciences, University of Southampton, Southampton, UK
| | - Elizabeth K Bancroft
- Urology Genetics, The Royal Marsden NHS Foundation Trust, Sutton, UK
- Oncogenetics Team, The Institute of Cancer Research, Sutton, UK
| | - Mary Jane Esplen
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Helen Hanson
- Peninsula Clinical Genetics Service, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
- Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Exeter, UK
| | - Karen Hurley
- Stanford R Weiss, MD Center for Hereditary Colorectal Neoplasia, Cleveland Clinic, Cleveland, Ohio, USA
| | - Katie Snape
- South West Thames Centre for Genomics, Clinical Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Diana Eccles
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Claire Foster
- Centre for Psychosocial Research in Cancer: CentRIC, School of Health Sciences, University of Southampton, Southampton, UK
| |
Collapse
|
3
|
Ferreira-Alfaya FJ, Zarzuelo-Romero MJ, Cura Y. Alignment of Patient Information Leaflets with the Health Literacy Skills of Future End-Users: Are We on the Same Page? HEALTH COMMUNICATION 2024:1-12. [PMID: 39129713 DOI: 10.1080/10410236.2024.2388887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Effective health communication will not be possible if the messages directed to patients do not adapt to their health literacy skills. In this sense, if the Patient Information Leaflets (PILs) are not understood properly, they will not fulfill their purpose. Secondary education aims to develop students' fundamental skills, including reading comprehension, which should align with future patients. This study assesses reading comprehension of commonly used PILs among secondary education students. An observational cross-sectional study involved 590 Spanish secondary school students from March to June 2022. They read 3 original PILs and completed a questionnaire about medication use information. The European health literacy survey questionnaire (short version) and sociodemographic data were collected. The average correct answer rate was only 51%, with just 14.58% understanding when to take ibuprofen, results that fell significantly below the minimum 80% threshold required by the European Union. Age, gender, and cultural background didn't significantly impact comprehension. In conclusion, health literacy skills acquired in secondary education are insufficient for understanding current PILs. Educational reform is necessary to improve students' ability to comprehend medication instructions and enhance PILs for effective communication. At the same time, our work highlights that current PILs need to be redesigned to reduce the cognitive burden imposed on patients.
Collapse
Affiliation(s)
| | | | - Yasmin Cura
- Department of Pharmacy and Pharmaceutical Technology, University of Granada
| |
Collapse
|
4
|
Wang Y, Wong ELY, Qiu H, Cheung AWL, Tang KS, Yeoh EK. The influence of written medication reminder on patient experience among older adult patients: a repeat cross-sectional study. BMC Geriatr 2024; 24:662. [PMID: 39112924 PMCID: PMC11304567 DOI: 10.1186/s12877-024-05253-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/26/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Older adult patients are particularly vulnerable to medication-related issues during the discharge process. To enhance medication discharge education and patient experience, a written medication reminder, incorporating crucial medication side effects and warning signs, was implemented in medicine wards. This study aimed to examine the influence of this reminder on patient experience and medication-taking behaviors among older adults in public healthcare settings. METHODS Two separate rounds of cross-sectional surveys were conducted before and after the program implementation among different discharged patients in each round. The study enrolled older adult patients aged ≥ 65 or their caregivers discharged from the medical wards of four pilot public hospitals in Hong Kong. A structured questionnaire was administered via telephone within 14 days of the patient's discharge. The survey assessed patients' experience with the provided medication information during discharge, including the clarity, adequacy, and usefulness of the information, as well as their overall experience with inpatient services. The self-reported medication-taken behaviors, including adherence and side-effect encounters, were also measured. RESULTS A total of 1,265 responses were collected before the implementation of the medication reminder, and 1,426 responses were obtained after the implementation. Pre/post-implementation survey comparison showed significant improvement in patient experience regarding the clarity of the provided medication information (7.93 ± 1.84 vs. 8.18 ± 1.69, P = 0.002), adequacy (7.92 ± 1.93 vs. 8.15 ± 1.76, P = 0.014), and usefulness (8.06 ± 1.80 vs. 8.26 ± 1.70, P = 0.017), significantly positive experience on the overall discharge information (β coefficient, 0.43 [95%CI, 0.30 to 0.56]) and inpatient service (β coefficient, 0.47 [95%CI, 0.32 to 0.61]). In addition, the side effects encounters were significantly lower in the post-implementation survey group (11.6% vs. 9.0%, P = 0.04) and no statistical difference was found in self-reported medication adherence between the two groups. CONCLUSIONS The provision of written medication reminders on key medication risks effectively improved older adult patients' experience and reduced side effects without any unintended negative consequences. The findings can serve as a reference for similar settings seeking to enhance post-discharge care among older adult patients. Future studies could investigate the influence in other specialties and age groups and include clinical outcomes to test the program's effectiveness.
Collapse
Affiliation(s)
- Yingxuan Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Hong Qiu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
5
|
Woolley A, Hadjiconstantinou M, Bodicoat DH, Khunti K, Davies MJ, Seidu S. A cross-sectional time series of cardiometabolic health education format preferences across sociodemographic groups. Diabet Med 2024:e15404. [PMID: 38994926 DOI: 10.1111/dme.15404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 06/07/2024] [Accepted: 06/25/2024] [Indexed: 07/13/2024]
Abstract
AIMS Health education is integral to cardiometabolic disease (CMD) management. This study aimed to assess whether and how education preferences have changed over time, and whether trends differ by sociodemographic characteristics (education status, age, ethnicity, and sex). METHODS A cross-sectional questionnaire was deployed across five counties in the East Midlands, UK between 2017 and 2022 to adults with CMD (type 2 diabetes, cardiovascular disease or cerebrovascular disease). Respondent demographic data were collected alongside health education preferences. Statistical analyses ascertained whether demographic characteristics influenced preferences. The distribution of preferences over time was charted to identify trends. RESULTS A total of 4301 eligible responses were collected. Face-to-face one-to-one education was preferred (first choice for 75.1% of participants) but popularity waned over the five-year period. Trends were similar amongst demographic groups. Online education showed a U-shaped trend: In 2017, 44% of respondents ranked it as acceptable, peaking at 53% in 2019, but declining again, to below base line, 43%, by 2022. This modality was more popular with participants aged younger than 65 years, but popularity in people older than 65 years increased over the study period. The popularity of printed information also declined over time across all demographic groups except those of South Asian ethnicity, for whom it remained static. CONCLUSIONS The overwhelming preference for face-to-face one-to-one health education from a doctor or nurse highlights the importance of preserving access to this modality, even in the face of current NHS pressures and trends towards digitalisation. Trends are changing, and should continue to be monitored, including between different sociodemographic groups.
Collapse
Affiliation(s)
- Angharad Woolley
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | | | | | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Samuel Seidu
- Diabetes Research Centre, University of Leicester, Leicester, UK
| |
Collapse
|
6
|
Frølund JC, Løkke A, Jensen HI, Farver-Vestergaard I. Development of Podcasts in a Hospital Setting: A User-Centered Approach. JOURNAL OF HEALTH COMMUNICATION 2024; 29:244-255. [PMID: 38420940 DOI: 10.1080/10810730.2024.2321385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Patient information plays a pivotal role in preparing individuals for hospital visits and empowering them to actively participate in decision-making processes regarding their healthcare. However, many patients face challenges related to reading comprehension. In response, podcasts have become a popular, user-friendly medium for sharing essential and easily understandable information in an engaging format.The aim of the present project was to use a user-centered approach to develop podcasts providing patient information prior to hospital visits. We aimed to describe the steps of the development in detail with the purpose of inspiring podcast development in the future.In Phase 1 we conducted interviews with patients and focus groups with clinicians based on the "empathy map" method, with the purpose of exploring patients' needs on which to subsequently build the podcasts' content and format. In Phase 2 we produced and refined the podcasts on the basis of feedback from clinician- and patients representatives.Our results indicated the importance of clear and concise language, personalization of communication, and content alignment with patients' needs. Our project resulted in a description of each step of the development that can be used as inspiration for others who wish to take a user-centered approach to podcast development.
Collapse
Affiliation(s)
- J C Frølund
- Department of Medicine, Vejle Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - A Løkke
- Department of Medicine, Vejle Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - H I Jensen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Anaesthesiology and Intensive Care, Vejle Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Anaesthesiology and Intensive Care, Kolding Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - I Farver-Vestergaard
- Department of Medicine, Vejle Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
7
|
Jones PR, Santiago J, Pearsall BM, Chu DM, Wolff C, Kearsley A. A survey on perceived medication guide reading and comprehension ease among US adults. Health Promot Int 2024; 39:daad190. [PMID: 38386901 DOI: 10.1093/heapro/daad190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Medication guides (MGs) provide patients with important information about certain prescription drugs to help them take these drugs safely. We surveyed US residents about their perceptions of MG readability and understandability. We randomly sampled 5204 US residents (age 18+) from Ipsos's KnowledgePanel to complete a two-part survey. Only respondents who reported receiving an MG with their prescription drugs (n = 3852) completed part 2, which included two key items: How easy to [(1)read/(2)understand] are the MGs that you have received from a pharmacy along with your prescription medicines? (1 = Very easy, 5 = Very difficult; reverse-coded). Health literacy (HL) and demographic data were also collected. After weighting our data, we found that 85% of respondents who reported receiving an MG perceived this information as 'very easy' (27.3%), 'somewhat easy' (28.3%) or 'about average' (29.3%) to read. Eighty-seven percent of respondents who reported receiving an MG perceived it as 'very easy' (27.6%), 'somewhat easy' (30.2%) or 'about average' (29.5%) to understand. ANOVAs revealed higher average perceived MG reading and comprehension ease scores among respondents presumed to have adequate versus inadequate HL (ps ≤ 0.0006). Younger or less-educated respondents and non-Hispanic Blacks perceived MGs as easier to read and understand, on average, than their counterparts (ps ≤ 0.0001). Many of these relationships remained intact in models predicting perceived MG reading and comprehension ease (ps ≤ 0.001). Adjusted R2 values across models were small, however (≤0.06). Our findings suggest most US residents (18+) who received MGs perceived them to be 'about average' to 'very easy' to read and understand.
Collapse
Affiliation(s)
- Paul R Jones
- Division of Medical Policy Programs, Office of Medical Policy Initiatives, Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Jonas Santiago
- Division of Medical Policy Programs, Office of Medical Policy Initiatives, Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Bryon M Pearsall
- Division of Medical Policy Programs, Office of Medical Policy Initiatives, Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Dan-My Chu
- Division of Medical Policy Programs, Office of Medical Policy Initiatives, Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Carolyn Wolff
- Office of Economics and Analysis, Office of Policy, Legislation, and International Affairs, Office of the Commissioner, FDA, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Aaron Kearsley
- Office of Economics and Analysis, Office of Policy, Legislation, and International Affairs, Office of the Commissioner, FDA, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| |
Collapse
|
8
|
Kohut K, Speight B, Young J, Way R, Wiggins J, Monje-Garcia L, Eccles DM, Foster C, Turner L, Snape K, Hanson H. Co-design of patient information leaflets for germline predisposition to cancer: recommendations for clinical practice from the UK Cancer Genetics Group (UKCGG), Cancer Research UK (CRUK) funded CanGene-CanVar Programme and the Association of Genetic Nurse Counsellors (AGNC). J Med Genet 2024; 61:142-149. [PMID: 38050080 DOI: 10.1136/jmg-2023-109440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/27/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Testing for germline pathogenic variants (GPVs) in cancer predisposition genes is increasingly offered as part of routine care for patients with cancer. This is often urgent in oncology clinics due to potential implications on treatment and surgical decisions. This also allows identification of family members who should be offered predictive genetic testing. In the UK, it is common practice for healthcare professionals to provide a patient information leaflet (PIL) at point of care for diagnostic genetic testing in patients with cancer, after results disclosure when a GPV is identified, and for predictive testing of at-risk relatives. Services usually create their own PIL, resulting in duplication of effort and wide variability regarding format, content, signposting and patient input in co-design and evaluation. METHODS Representatives from UK Cancer Genetics Group (UKCGG), Cancer Research UK (CRUK) funded CanGene-CanVar programme and Association of Genetic Nurse Counsellors (AGNC) held a 2-day meeting with the aim of making recommendations for clinical practice regarding co-design of PIL for germline cancer susceptibility genetic testing. Lynch syndrome and haematological malignancies were chosen as exemplar conditions. RESULTS Meeting participants included patient representatives including as co-chair, multidisciplinary clinicians and other experts from across the UK. High-level consensus for UK recommendations for clinical practice was reached on several aspects of PIL using digital polling, including that PIL should be offered, accessible, co-designed and evaluated with patients. CONCLUSIONS Recommendations from the meeting are likely to be applicable for PIL co-design for a wide range of germline genetic testing scenarios.
Collapse
Affiliation(s)
- Kelly Kohut
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
- Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Beverley Speight
- Clinical Genetics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Rosalind Way
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Jennifer Wiggins
- Cancer Genetics, The Royal Marsden NHS Foundation Trust, London, UK
| | - Laura Monje-Garcia
- The St Mark's Centre for Familial Intestinal Cancer, London North West University Healthcare NHS Trust, London, UK
- Imperial College London, London, UK
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Claire Foster
- Centre for Psychosocial Research in Cancer: CentRIC, University of Southampton, Southampton, UK
| | | | - Katie Snape
- Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
- St George's University of London, London, UK
| | - Helen Hanson
- Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| |
Collapse
|
9
|
Seeballuck C, Dolan S, K Kilgariff J. Getting it right at every stage: Top tips for traumatic dental injury review: Part 1. Br Dent J 2024; 236:82-86. [PMID: 38278886 DOI: 10.1038/s41415-024-6780-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Affiliation(s)
- Clement Seeballuck
- Clinical Lecturer in Paediatric Dentistry, Dundee Dental Hospital and Research School, Dundee, DD1 4HR, UK.
| | - Sean Dolan
- Specialty Training Registrar in Restorative Dentistry, Glasgow Dental Hospital and School, Glasgow, G2 3JZ, UK.
| | - Julie K Kilgariff
- Consultant in Endodontics, Dundee Dental Hospital and Research School, Dundee, DD1 4HR, UK.
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|