No abstract

Of the 411 patients notified with tuberculosis in Leeds during 1986 through 1991, case notes were available on 406 (99%) and the diagnosis of mycobacterial disease was accepted in 397 (98%). Twenty-two patients had infection with atypical mycobacteria and were excluded from analysis, as were children under 16 years. Comparison between the age groups was further restricted to white patients because of a skew distribution of Asian patients towards the younger age range. Ninety-six elderly patients (aged 65 years and older) were compared with 127 younger patients. The distribution of pulmonary and extrathoracic disease was similar as was the incidence of positive bacteriology. Elderly people had more frequent lower-zone and more frequent miliary shadowing, otherwise radiographic features were similar. Elderly people were nearly three times more likely to have reactions to antituberculous drugs, six times more likely to die from tuberculosis and over twenty times more likely than younger patients to have the diagnosis made at autopsy rather than during life.

leaflets asIn the United Kingdom, patient information leaflets (PILs) are now supplied with all medicines licensed or re-licensed since January, 1994. This means that, by 1998, all medicines wiU come with one of these detailed leaflets inside the pack. In a preliminary investigation of the impact of these leaflets, 11 7 elderly inpatients were questioned on their experience of PILs prior to admission. Ninetyone (78 per cent) said they had received a PIL and 57 (49 per cent) had read one. The main reasons for not reading a leaflet were the perceived difficulty in understanding and being put off by excessive information. Of the patients who had read a leaflet, 23 (40 per cent) reported difficulty in reading the small print and 26 (46 per cent) said they had difficulty understanding the content. Thirteen patients (23 per cent) reported having to seek help with reading a leaflet. Forty-two of those who had read a leaflet rated it as helpful. Eleven patients said they had asked for advice from their doctor or pharmacist as a result of reading a leaflet. Nine patients said the leaflet had caused some anxiety, with two s t o p ping their medicine as a result. The move to universal PILs in patient packs is a major development in the provision of information to patients about medicines. This study suggests that elderly patients have problems relating to understanding the content of PILs and reading the size of print used in these leaflets. THE provision of information for patients in the health service is an area of rapid growth.1 While in the past patients may have relied on their doctor or pharmacist for details of medication and other treatments, there is an increasing interest in conveying this information by more specific means. Perhaps the most familiar of these is the patient information leaflet (PIL). . Previous research from Southampton showed widespread public support for written information on prescribed medicines. In the Southampton studies, patients received unfolded leaflets printed on thin card, handed over by the doctor or pharmacist. Results from self-completed questionnaires showed that those who received the leaflets were not only better informed about their medicines, but also more satisfied with the information they received.2Since January, 1994, the provision of a detailed PIL is a requirement for the licensing of all new drugs in the United Kingdom and this also applies at the time of re-licensing. This means that by 1998 all drugs will be supplied with a PIL inside a patient pack.3Although previous research into PlLs has shown considerable potential value, their effect when provided universally as package inserts (ie, on lightweight folded paper and sealed inside the pack) have not been assessed. A recent article in the Drug and Therapeutics Bulletin, examining the influence of routine provision of PILs, called for further research on their effects.3The aim of this study was to assess the effects of PILs as package inserts as previously experienced by a hospital inpatient population. MethodsA quest...

No abstract

No abstract