|
 Patients
say drug leaflets are hard to read, understand
By Laura
Kennedy, Contributing Writer
Health Behavior News Service
Patients report that leaflets provided with prescription drugs do
not meet their needs, according to a new systematic review. Instead,
poor layout and complex language often hinder communication.
Review
studies confirm that written drug information does not improve
patient understanding of their medications. Many people would like
information that better helps them evaluate potential benefits and
harms of a drug treatment.
“If you’re going to have safe and effective medicines use, then we
need to give patients the tools to do that job,” says lead author
D.K. Raynor, Ph.D., of the University of Leeds in England.
The reviewers emphasize that patients want written
information in addition to — not instead of — spoken
instructions from their health care professionals.
According to the Partnership for Clear Health
Communication, nearly half of all American adults
have difficulty understanding and using health
information.
In fact, the organization says, literacy skills are
a stronger predictor of an individual’s health
status than age, income, employment status,
education level or racial/ethnic group.
The
review is published in the latest issue of Health Technology
Assessment, the international journal series of the Health
Technology Assessment programme, part of the National Institute
for Health Research in the United Kingdom.
The authors reviewed 70 quantitative and qualitative studies carried
out in the United Kingdom, Europe, Australia and the United States.
They also conducted two patient workshops and delved into texts on
information design to identify best practices.
The studies varied considerably in setting and timing, and reporting
of interventions and methodological quality was often poor, the
review authors say. For this reason, the experts detailed their
findings in a nearly 200-page monograph rather than pooling the data
for statistical analysis.
One key finding was an apparent dichotomy between prescriber and
patient views of the fundamental purpose of drug leaflets, the
authors say.
Some providers see increasing treatment compliance as a primary
function. In contrast, patients say an informed decision not to take
a medicine is also an acceptable result.
“Patients see the role of written medical information as guiding
them in terms of which medicine is right for them and, if they take
the medicine, how best they can use it,” Raynor said. To that end,
patients would also like to see more balance between benefit and
harm information.
Current drug information focuses too heavily on warnings and adverse
effects of the medication, Raynor said. “Patients also need to know
how it might benefit them and how likely it is to benefit them.”
Exactly how to convey the likelihood of benefits and harms most
clearly remains in question. Verbal descriptors like “rare” or
“common” are too vague, according to the review.
Yet, more scientific terminology like percentages or “numbers needed
to treat” can also confuse the lay public. More research is needed
in how best to communicate probability data to consumers, the
reviewers say.
Raynor said that studies showed that poor layout of drug leaflets is
a particular problem in the United States: “The information can be
very dense, and the headings can be very indistinct. It can be very
difficult to navigate.”
To help drug companies produce more user-friendly consumer
information, the authors reviewed six texts recommended by experts
in information design to identify best practices. Recommendations
include
• Use short, familiar words and short sentences.
• Use short headings that stand out.
• Use the largest possible type size.
• Leave plenty of white space.
• Use bullet points to organize lists.
“That’s probably one of the most important parts of the review,”
Raynor said.
“This resource can help make leaflets in the way that patients find
them useful.”
In 2005, the European Union took an important step forward by
requiring pharmaceutical companies to test their leaflets on
patients before they begin marketing a product.
“Some [European] companies have started to realize how important the
leaflets are,” Raynor said. “Changing them and making them more
valued for patients really is in their interests.”
One U.S. company that is following suit is Pfizer, Inc.
“We moved all of our patient education materials around our brand
down to the sixth-grade reading level,” said Barbara DeBuono, M.D.,
the company’s senior medical advisor for public health. She is also
board chair at the Partnership for Clear Health Communication.
“Health literacy is not only the ability to read and understand
information, but to act on the information,” DeBuono added. “There’s
nothing more de-motivating for a patient than to find the
information confusing, unintelligible and inaccessible.”
The review authors call for more robust, patient-focused research on
improving content, delivery and layout of written drug information.
They add that none of the studies in the current review covered
Web-based medicines information, which will surely be an emerging
field of study in the future. |
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