United Kingdom national media representations of medications used in dementia: a systematic content analysis

Abstract

Abstract Introduction Newspapers contribute to public understanding and perceptions of health-related issues (1,2). Examination of news media reporting to elucidate how the public conceptualise and understand medicines use in dementia has been limited to date. Aim To investigate communication to the public about medications used in dementia via newspaper articles. Methods A systematic content analysis explored communication in the 10 highest circulated UK newspapers about medications used in dementia, over a 10-year period from 2010 to 2019. LexisNexis UK was searched using terms relating to medications and treatment in dementia (both for dementia and for other co-morbid conditions), and articles relating to medicines use in dementia were identified for inclusion. A standardised coding frame was developed, piloted, and used to code all included articles across three domains: structure (bibliographic details); content (information within each article); and judgement and rating (subjective variable related to information presented, and scored from 0-10). Where an article was linked to a scientific journal article, this was retrieved, and the content cross-checked. A second researcher independently coded a random sample (10%) of articles. Level of intercoder agreement was determined by calculation of Cohen’s kappa value. Results One hundred articles satisfied the inclusion criteria. The newspapers which most frequently contained relevant articles were: the Daily Mail (n = 33) and the Daily Express (n = 30), followed by the Daily Mirror (n = 12), the Guardian (n = 11), the Mail on Sunday (n = 5), the Sunday Express (n = 3), the i (n = 3), the Metro (n = 1), the Daily Star (n = 1) and the People (n = 1). The largest numbers of articles were published in 2011 and 2012 (n=18) and the smallest number in 2019 (n = 4), with no apparent trend observed over the study period. Main article themes were: benefits and effectiveness, risk and harm, lack of diagnosis, and funding and potential future drug developments. Starting therapy early and continuing in later stages of dementia were reported to maintain function and independence and slow decline. Antipsychotics, sedatives and opioid analgesics were considered to worsen symptoms and increase risk of death. Lack of dementia diagnosis resulted in inability to obtain dementia medication when people needed and would benefit from it. Lack of funding was highlighted as a barrier to research. Most articles were written from a clinical perspective (n=82). Half had a negative slant, 46% had a positive slant and 4% were neutral. Almost half were judged to be excellent quality (45%), 35% were considered average and 20% were judged as poor quality. Cohen’s kappa values ranged from 0.63 to 1.00, indicating satisfactory agreement between coders. Conclusion There remains scope for improvement in quality of mass media communication regarding medications used in dementia. Strengths of this study include the systematic approach employed in content analysis, while limitations include exclusion of the Sun, the Times and the Telegraph due to lack of availability of circulation figures, and exclusion of media sources other than newspapers. References (1) Akintola O, Lavis JN, Hoskins, R. Print media coverage of primary healthcare and related research evidence in South Africa. Health Res Policy Syst. 2015;13:68. (2) Stanford FC, Tauqeer Z, Kyle TK. Media and its influence on obesity. Curr Obes Rep. 2018; 7(2):186–92.