Attitude of the Public toward Technical Package Inserts for Medication Information in Belgium

Abstract

We designed an 84-item questionnaire to determine the attitude of the Belgian public toward package inserts (PI) for medication information, written in technical language and intended for health professionals, within an original drug-dispensing distribution system. There were 398 respondents to this general public survey, based on a 0.05 percent selection from election registers of the districts of Gent and Liège. Eighty-nine percent of the respondents read the PI, focusing their attention principally on adverse effects (88 percent), dosage and dosing guidelines (85 percent), contraindications (82 percent), indications (79 percent), and medication shelf-life (76 percent). Compliance (83 percent), reassurance (57 percent), increased knowledge about the medication (50 percent), and decision to take the medicine (31 percent) were among the respondents' motives for reading the PI. Most respondents considered the PI information useful and complete, but difficult to remember and understand. Readers further criticized its legibility and poor graphic illustration. The PI was seen as a supplementary source of information, instrumental to the physician-pharmacist-patient relationship, without the power to overrule the physician's or pharmacist's instructions. Some respondents reported that the PI made them afraid to use the medication. Expectations for the ideal PI were contradictory and can only be met with a never-optimal compromise between comprehensiveness and conciseness.

A systematic review of quantitative and qualitative research on the role and effectiveness of written information available to patients about individual medicines

“…However, the discussion section of the papers implied that some authors judged 'success' as a majority of patients reading the information. Relatively 'lower' levels were reported by Raynor and Knapp (40%) 63 and Bandesha (49%) 55 and high levels by Vander Stichele and colleagues (89%), 65 Koo and colleagues ('most' patients in their qualitative study) 60 and De Tullio and colleagues (82%). 57 Morris and colleagues reported high levels for a shorter insert (88%) but lower for a brochure (33%).…”

“…60 Of the seven surveys, one was 'hypothetical' (see above) in that participants were not selected because they had had recent exposure to written (32) medicines information. 65 Hospital patients in Bandesha's survey were questioned about written information that they had received with medicines at home. It was not clear here what medicines information patients may have had in mind when they were responding in the structured interview.…”

“…Ten studies focused on patients, 53,55,57,58,[60][61][62][63]65,77 one on health professionals 64 and two included both.…”

“…Seven were surveys, 55,[61][62][63][64][65]77 one an intervention study 57 and four were laboratory-based exercises. 53,56,58,59 Although not always explicitly reported, it seemed that most of the questionnaires did not have any or many open questions but included response categories predetermined by the researcher.…”

“…A response to policy initiatives relating to written medicines information (12 studies). 53,[55][56][57][58][59][60][61][62][63][64][65] 2. The 'uninformed' patient and the certainty of professional knowledge and the consequent need to educate the patient (eight studies).…”