Use Of Patient Information Leaflets Research Articles

Use of Patient Information Leaflets in the Algerian Context. Current Situation and Regulatory Framework

This paper aims to present the marketing and translation process of patient information leaflets (PILs) into Arabic and their accessibility to the public, taking the Algerian market as a case study. PILs are the main source of information related to medication and are required to be lay-friendly as part of the process of marketing authorization. Lay-friendliness in the Algerian context means that the information contained in the PILS, (1) is conveyed through the receiver language, i.e., Arabic, and (2) is written in a language that is understandable by the receiver. To test these hypotheses, an assessment of the regulatory framework of PILS in the Algerian context was carried out. Furthermore, a study was conducted based on 1) a questionnaire targeting 56 participants to assess the readability of PILS, and 2) a field survey in pharmaceutical laboratories to document the translation stage in the marketing process. The assessment showed that the use of Arabic is mandatory in addition to a foreign language. The questionnaire showed that participants tend to read the Arabic content of the PIL. The survey’s results reported that the translation task is delegated to a sworn translator’s office though the examination of 16 randomly-selected (out of 72 PILs) revealed some linguistic discrepancies.

331 Patient experience in a Falls and Syncope service in a large Irish teaching hospital

Abstract Background The measurement of patient satisfaction provides valuable information about patients’ perceptions of their received healthcare. It is an excellent measure of the quality of care delivered by a healthcare facility. This allows service providers to continue to move towards patient-centred care. A positive patient experience is an important aim that leads to better clinical outcomes. Methods A 20-question patient satisfaction survey was developed for an outpatient Falls and Syncope Unit in order to assess the patient’s perception of service delivery. All patients attending the service were invited to complete the survey over a 2-month period in 2022. Results 71 responses were received. 76% of respondents found their appointment beneficial, and 94% felt their appointment was necessary. Satisfaction with staff ranged between 97–99%. 98% of patients felt they were treated with respect and 88% felt free to express complaints, with 97% satisfactory telephone interaction with the service. 60% of patients received a patient information leaflet, with 97% of patients finding the information leaflets provided useful. Twenty-five respondents (31%) indicated further information on their care would have been beneficial. Conclusion This patient satisfaction survey provided positive feedback for all staff on care delivered in the Falls and Syncope service. Recommendations for changes in practice included increased use of patient information leaflets, in order to improve patients’ experience, since 97% of patients found information leaflets useful and 40% of patients did not receive a leaflet.

412 Knowledge and Practices for the Prevention of the Diabetic Foot in North Wales

Abstract Aim Diabetes mellitus can result in a wide range of foot complications such as ulceration, infection, and amputation. The National Institute for Health and Care Excellence (NICE) recommend that all diabetic patients should receive verbal and written information relating to their foot care. Here we assess our compliance with the national guidelines and the levels of patient knowledge amongst the diabetic population in the North West of Wales. Method A questionnaire was provided to all adult diabetic patients attending the outpatient podiatry service over the course of three weeks at Ysbyty Gwynedd, North Wales. The survey included compliance and knowledge-based questions regarding foot care. Results A total of 65 patients were recruited and completed questionnaires. The majority of the patients were males (male:female ratio 2:1) and over 70 years and had type II diabetes. 98% of patients admitted to receiving verbal diabetic advice while only 57% received written information. Compliance with daily foot checks was 82%. Regarding patient knowledge, over 90% of patients selected the correct answer to 11 out of the 15 knowledge-based questions. Despite 95% recognising that poor footwear can contribute to diabetic foot complications, only 86% recognised that walking barefoot carries similar risks. Conclusions Diabetic foot knowledge is high within our studied population. Use of patient information leaflets can be further improved to help educate patients in avoiding barefoot walking and to prevent diabetic foot complications and limb loss.

781 IMPROVING THE QUALITY OF DO NOT ATTEMPT CARDIO-PULMONARY RESUSCITATION (DNACPR) FORM COMPLETION

Abstract Introduction The completion of a Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) form represents an important part of patient care. However, this can be a sensitive process that has gained national media interest. The aim of this Quality Improvement (QI) Project was to improve the quality of DNACPR form completion in a Care of the Elderly Department. Methods The QI project ran from May 2019 to January 2021 and was overseen by a multi-disciplinary team (including patient representation). DNACPR forms on the Care of the Elderly wards were audited monthly against 7 standards which correspond to key sections on the DNACPR form. During the data collection process, interventions were implemented using Plan-Do-Study-Act cycles. Interventions included: appointing ‘DNACPR Champions’ to complete monthly audits and provide personalised clinician feedback, the introduction of a new mandatory e-learning module, the creation of an alert system on nerve centre (the Trust’s electronic handover system) and the development of new DNACPR patient information including webpage development, videos and leaflets. Results The project has led to sustained improvements in majority of the 7 standards. The biggest improvements were seen in the inclusion of a review date, correct completion of the mental capacity assessment and the use of patient information leaflets. The documentation of discussions with patient and relatives remained below the audit standards and was largely unchanged during the QI project. Conclusion A multi-disciplinary and multi-faceted QI approach has shown to improve the quality of DNACPR form completion. Further work is needed to continue this process and a focus on staff training and ward-level processes will be the priority.

Divergent and Convergent Attitudes and Views of General Practitioners and Community Pharmacists to Collaboratively Implement Antimicrobial Stewardship Programs in Australia: A Nationwide Study.

Setting up an interprofessional team for antimicrobial stewardship (AMS) to improve the quality and safety of antimicrobial use in primary care is essential but challenging. This study aimed to investigate the convergent and divergent attitudes and views of general practitioners (GPs) and community pharmacists (CPs) about AMS implementation and their perceived challenges of collaboration to design a GP–pharmacist collaborative AMS (GPPAS) model. Nationwide surveys of GPs and CPs across Australia were conducted January-October 2019. Chi square statistics and a theoretical framework were used for comparative analyses of quantitative and qualitative data, respectively. In total, 999 participants responded to the surveys with 15.4% (n = 386) response rates for GPs and 30.7% (n = 613) for CPs. GPs and CPs were aware about AMS however their interprofessional perceptions varied to the benefits of AMS programs. CPs indicated that they would need AMS training; significantly higher than GPs (GP vs. CP; 46.4% vs. 76.5%; p < 0.0001). GPs’ use of the Therapeutic Guideline Antibiotic was much higher than CPs (83.2% vs. 45.5%; p < 0.0001). No interprofessional difference was found in the very-limited use of patient information leaflets (p < 0.1162) and point-of-care tests (p < 0.7848). While CPs were more willing (p < 0.0001) to collaborate with GPs, both groups were convergent in views that policies that support GP–CP collaboration are needed to implement GPPAS strategies. GP–pharmacist collaborative group meetings (54.9% vs. 82.5%) and antimicrobial audit (46.1% vs. 86.5%) models were inter-professionally supported to optimise antimicrobial therapy, but an attitudinal divergence was significant (p < 0.001). The challenges towards GP–CP collaboration in AMS were identified by both at personal, logistical and organisational environment level. There are opportunities for GP–CP collaboration to improve AMS in Australian primary care. However, strengthening GP–pharmacy collaborative system structure and practice agreements is a priority to improve interprofessional trust, competencies, and communications for AMS and to establish a GPPAS model in future.

Survey of healthcare professionals' practices, expectations, and attitudes towards provision of patient information leaflets in Thailand.

Background Patient information leaflets are an important source of medicine information for patients. In Thailand, there is a lack of studies exploring activities of healthcare professionals and their attitudes towards provision of patient information leaflets. Objectives This study aimed to survey healthcare professionals' practices on provision of medicine information, expectations of, attitudes towards provision of patient information leaflets and factors influencing these. Setting Two university hospitals in Thailand. Methods A self-completion questionnaire was distributed to chiefs of departments for further distribution to staff. A stratified sample of physicians and nurses was invited, while all pharmacists were invited to ensure sufficient numbers for comparison. Main outcome measure Healthcare professionals' practices on provision of medicine information, expectations of, attitudes towards provision of patient information leaflets. Results Of the total 981 healthcare professionals invited, 493 responded (50.3% response rate). The number of respondents aware of patient information leaflets was 270 (57.6%). Of these, only 44.4% had ever given patient information leaflets to patients. Pharmacists provided patient information leaflets more frequently than other healthcare professionals. The expectation for patient information leaflets to be available was high; mean score 7.9 ± 2.31 of possible 10. Most respondents had positive attitudes towards providing patient information leaflets to patients (58.2%). Respondents who were aware of patient information leaflets availability were more likely to have a positive attitude (OR 0.543, p = 0.002). Level of education, time spent in direct care and being aware of patient information leaflets were factors associated with healthcare professionals' attitudes. Conclusion Limited number of healthcare professionals had provided patient information leaflets to patients but most had positive attitudes regarding the usefulness of patient information leaflets for patients. Increased availability and use of patient information leaflets should be promoted.

IMPACT OF PHARMACIST INTERVENTION ON MEDICATION KNOWLEDGE AND ADHERENCE IN HEMODIALYSIS PATIENTS

Objective: The objectives of the study are to evaluate the medication knowledge and medication adherence in patients undergoing haemodialysis and to educate the patients regarding the importance of medication adherence through counseling by providing Patient Information Leaflets and to analyze its impact.&#x0D; Methods: 50 Patients were randomly divided into two groups (control and test). Patient data was collected and documented using the patient data collection form after obtaining their consent. Their knowledge and medication adherence were assessed using questionnaires and was quantified. Patients included in the test group were counseled using Patient Information Leaflets whereas the control group was not counseled. Re-assessment was done during follow up for both groups.&#x0D; Results: Paired t-test was done to check if there was a significant difference in both the test and control group, with and without the use of Patient Information Leaflets respectively. The study showed that the test group had significant improvement (P&lt;0.05) in their medication adherence and knowledge whereas there was no significant change in the control group.&#x0D; Conclusion: Providing patient counseling and continuous education with efforts to improve awareness among haemodialysis patients could enhance adherence to therapies and thus could improve clinical outcomes and quality of life.

Survey of outpatients' use and needs of patient medicine information leaflets in Thailand.

Background Patient information leaflets are important sources of medicine information. Regulations of patient information leaflet provision varies among country. Little is known regarding patients' behavior and expectation on use of patient information leaflets. Objectives To explore patients' use of either package inserts or patient information leaflets and to survey patients' expectations and needs on use of patient information leaflets and their associated factors. Setting Two university hospitals in Thailand. Methods Cross-sectional study using self-administered questionnaires distributed to outpatients over a 3-month period. Participants were selected through systematic random sampling. Logistic regression was used for data analysis. Main outcome measure Patient use of medicine information. Visual Analogue Scale scores for patient needs and their expectation of knowledge gains from using patient information leaflets. Results The response rate was 77.0%. Most respondents had received package inserts (91.3%) with 59.4% reporting that they sometimes read them. While most respondents had not previously known about patient information leaflets (75.9%), 97.3% reported that patient information leaflets would be useful. Respondents scored their needs and expected knowledge gains after reading patient information leaflets as 9.68 ± 0.97 and 9.64 ± 0.99, respectively. Previous experience with package inserts was associated with increased patient need scores (p = 0.002) and higher expected knowledge gains from use of patient information leaflets (p = 0.037). In addition, patients who had not previously known about patient information leaflets had higher expectations of knowledge gains (p = 0.016). Conclusion Overall, patients showed good behavior on reading package inserts. Although many patients were not previously aware of patient information leaflets, they realized the importance. Hence, patient information leaflets should be developed and provided to Thai patients.

Sexual health-related information delivery - are patient information leaflets still relevant?

Background Patient information leaflets (PILs) are widely utilised within publically funded sexual health clinics to deliver sexual health-related information (SHRI); however, their continued value to clients in the era of social media is unclear. This study aimed to evaluate clients' opinions on three newly developed PILs and examine client views on other forms of SHRI delivery. An anonymous self-administered questionnaire was completed by clients attending the Western Sydney Sexual Health Centre (WSSHC) in 2012. High-risk population (HRP) vs non-high-risk population (non-HRP) views on PILs vs alternative methods of SHRI delivery were analysed by using Mann-Whitney U, Wilcoxon, McNemar and χ(2) tests. Over half (210/315; (67%)) of the consecutive clients from a culturally diverse population completed the survey. Sex workers (SW) and young people (YP) were significantly likely to have a high school education than non-HRP (P<0.039 and P<0.032). Overall, PILs, a clinic website and the Sexual Health Information Link (SHIL), a state-wide website and telephone line, were ranked significantly higher as a means of SHRI delivery on a Likert scale than newer technologies including Facebook (P<0.001), email (P<0.001), mobile phone applications (P<0.001), TVs in waiting rooms (P<0.001) and business cards (P<0.001). There was no significant difference in opinion between HRP and non-HRP. This study provides evidence for the ongoing use of PILs to deliver SHRI to clinic attendees, in conjunction with other forms of SHRI delivery such as websites and SHIL. Novel methods may require additional consumer engagement and a greater understanding of specific population's needs.

How do patients use medicine information leaflets in the UK?

Abstract Objective To determine how patients use patient information leaflets (PILs) for prescription medicines. Setting Community pharmacies and patients' homes in the North of England. Method Patients were recruited as they collected their prescriptions, and telephoned about 7 days later. A structured telephone interview was administered with questions about how the PIL had been used (either this time or from previous prescriptions). Key findings Structured telephone interviews were completed for 456 patients (81% of those who consented), with a mean age of 54 years. Almost all patients (97%) were aware of the leaflet, a significant improvement on previous studies. Thirty-five per cent said they had read at least some of the leaflet with this supply. However, this figure was 71% for first-time users, and 87% of repeat users said they had read the leaflet at some time in the past. Of repeat users, nearly 60% said they had never or rarely looked at the leaflet after the first time. The side-effects section was most commonly read, and the information in this section was the most common specific reason given for reading the PIL. Eleven per cent of first-time users and 15% of repeat users said they had at some time taken action as a result of reading the PIL. Conclusions Almost all patients surveyed were aware of the PIL, showing that 8 years after becoming mandatory, the presence of the leaflets is now being felt. It is encouraging that most read the leaflet with the first supply, although the same cannot be assumed for very old individuals, who were under-represented. The fact that a majority taking a medicine long term did not read the leaflet again, after the first time, is a concern. Much will have been forgotten and some information may have changed. Pharmacists continue to have a role in encouraging the use of PILs.

Patient information leaflets on psychotropic drugs: opinions and use by psychiatrists

Aims and MethodTo assess circumstances and frequency of use, opinions and suggestions for improvement from psychiatrists in a teaching hospital on UK Psychiatric Pharmacy Group patient information leaflets for psychotropic drugs. We also sought information from psychiatrists regarding use of alternate sources of information provision for their patients on psychotropic drugs. A questionnaire was designed, piloted and distributed.ResultsSixty-one psychiatrists were approached, of whom 49 (80%) responded. the most common indications for use were when initiating a new treatment and when information is sought by the individual or their carers. the most common reason for not using these leaflets was lack of awareness of their existence. Although 33 (67%) responders were of the opinion that these leaflets were useful for patients, only a small proportion was using them frequently.Clinical ImplicationsOur study suggested increasing awareness among psychiatrists to encourage the use of patient information leaflets. Various other themes to improve their use also emerged including easy accessibility to the patient information leaflets, modification in the content and structure, and recording the provision of patient information leaflets in the case records.

Attitudes and behaviors of practicing community pharmacists towards patient counselling

The present study was conducted to assess the attitudes and behaviors of practicing community pharmacists towards patient counselling and use of patient information leaflets in the state of Karnataka. Convenient sampling method was adopted to collect the responses with the help of self-completion questionnaires. A total of 258 practicing community pharmacists in the age group of 22–60 y of both gender with practicing experience of 2-30 y participated in the study. Majority of respondents (80%) agreed that, patient counselling is their professional obligation. About 17% of the respondents mentioned that, they try to give basic information regarding drug usage to the patient. The reasons stated by the pharmacists to provide patient counselling were, professional satisfaction (43%), patients go with satisfaction (32%), observed increase in sales (8%), and also improved patient compliance (7.5%). The major barriers for offering patient counselling were mentioned as pharmacists' inadequate knowledge and confidence (78%), doctor dispensing (72%), no professional fee (56%), poor response from patients (82%), inadequate continuous professional development programs (75%). Many respondents agreed that, patient information leaflets certainly help in counselling but available information leaflets are company generated and prescriber focused. Many respondents found the present continuing professional development module was useful and are interested in weekend workshops to update their professional knowledge (83%). Restrictions on doctor dispensing, legalization of patient counselling, regular continuing professional development programs are the factors observed to motivate the pharmacists to offer patient counselling.

Patient information leaflets in surgical practice: a contemporary review.

Undergoing any surgical procedure, however minor this may be, generates a certain degree of anxiety amongst the patients, which is primarily related to the possible postoperative course and complications. Introduction of Patient Information Leaflets (PIL) in routine surgical practice has helped ameliorate this problem significantly and therefore has become a standard practice in the United Kingdom and elsewhere. This review highlights the evidence available in support of the use of PIL and outlines the process of development of PIL in surgical practice.

Balancing information needs: dilemmas in producing patient information leaflets

The aim of this paper is to depict and debate current issues in the production and use of patient information leaflets. To achieve this, the paper explores a number of assumptions that underpin the production of written information in healthcare; namely that information is a commodity conveyed through the printed word or electronically, and that health professionals ‘have’ information which can be ‘given’ to patients. Drawing on research conducted in palliative care, these issues are considered from the perspectives of patients. Data collected using focus groups highlight the problematic nature of the presentation and content of written patient information. In particular, tensions are revealed in the wishes of patients for general advice versus specific information, tensions between the wish to have full accounts and the wish to limit accounts that display unpalatable and potentially threatening prognostic information. It is proposed that information is inherently value laden and written with the intention to persuade and influence others. The paper concludes with suggestions for using new methods of research which seek to deconstruct text and examine the discourses which underpin their production.

Writing wrongs? An analysis of published discourses about the use of patient information leaflets

Much has been written about how to communicate with patients, but there has been little critical scrutiny of this literature. This paper presents an analysis of publications about the use of patient information leaflets. It suggests that two discourses can be distinguished in this literature. The first of these is the larger of the two. It reflects traditional biomedical concerns and it invokes a mechanistic model of communication in which patients are characterised as passive and open to manipulation in the interests of a biomedical agenda. The persistence of the biomedical model in this discourse is contrasted with the second discourse, which is smaller and more recent in origin. This second discourse draws on a political agenda of patient empowerment, and reflects this in its choice of outcomes of interest, its concern with the use of leaflets as a means of democratisation, and its orientation towards patients. It is suggested that the two discourses, though distinct, are not entirely discrete, and may begin to draw closer as they begin to draw on a wider set of resources, including sociological research and theory, to develop a rigorous theoretically grounded approach to patient information leaflets.