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Healthy Skepticism Library item: 12144

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Raynor DK, Svarstad B, Knapp P, Aslani P, Rogers MB, Koo M, Krass I, Silcock J.
Consumer medication information in the United States, Europe, and Australia: a comparative evaluation.
J Am Pharm Assoc (2003) 2007 Nov-Dec; 47:(6):717-24
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=18032134


Abstract:

OBJECTIVE: To evaluate the quality of patient information leaflets provided with dispensed medications in the United States, United Kingdom, and Australia. DESIGN: Quantitative survey by an expert panel. SETTING: United States, United Kingdom, and Australia. PARTICIPANTS: Not applicable. INTERVENTION: Patient information leaflets for atenolol, glyburide (glibenclamide), atorvastatin, and nitroglycerin (glyceryl trinitrate) from the United States, United Kingdom, and Australia. MAIN OUTCOME MEASURES: Leaflets were evaluated against U.S. consensus criteria for both clinical information and general criteria, including the design of the leaflets. RESULTS: Leaflets from Australia received a mean overall score of 90% (range 83%-94%) adherence with criteria, those from the United Kingdom a score of 81% (range 73%-84%), and those from the United States a score of 68% (range 65%-77%). The U.S. leaflets achieved 50% or less adherence for contraindication and precaution information. Omissions included warnings about preexisting allergy and illness and information about drug interactions. The U.S. leaflets also scored poorly (60%) for legibility and comprehensibility. The lower U.K. score reflected shortcomings in information about how to use and monitor the medications (46% adherence) and on adverse drug reactions (64%), largely due to the lack of clear advice about urgency of action in relation to adverse drug reactions. CONCLUSION: Leaflet quality varied more among the three countries than within each country, reflecting the regulatory context. The Australian leaflets performed well across all criteria, whereas the U.S. leaflets had significant shortcomings with the omission of vital information for the safe and effective use of the medications. A repeat survey is needed to assess whether new legislation and guidance in all three countries successfully addresses the shortcomings identified.

Keywords:
Australia Community Pharmacy Services/standards* Consumer Participation Drug Labeling/standards* Great Britain Humans Information Dissemination Pamphlets* Patient Education as Topic/standards* Professional Competence United States

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909