Enhancing provision of written medicine information in Australia: pharmacist, general practitioner and consumer perceptions of the barriers and facilitators

BMC Health Services Research

Parisa Aslani¹  David K Raynor²  Kim K Hamrosi¹ 

[1] Faculty of Pharmacy, The University of Sydney, Pharmacy & Bank Building A15, Sydney NSW 2006, Australia;School of Healthcare, University of Leeds, Leeds LS2 9UT, UK

关键词: General practitioners;    Community pharmacists;    Facilitators;    Barriers;    Information-sharing;    Patient education;    Written medicine information;   

Others  :  1132680
DOI  :  10.1186/1472-6963-14-183

 received in 2013-10-28, accepted in 2014-04-14,  发布年份 2014

【 摘 要 】

Background

Written medicine information can play an important role in educating consumers about their medicines. In Australia, standardised, comprehensive written information known as Consumer Medicine Information (CMI) is available for all prescription medicines. CMI is reportedly under-utilised by general practitioners (GPs) and community pharmacists in consultations, despite consumer desire for medicine information. This study aimed to determine consumers’, GPs’ and community pharmacists’ preferences for CMI provision and identify barriers and facilitators to its use.

Method

Structured questionnaires were developed and administered to a national sample of Australian consumers (phone survey), community pharmacists and GPs (postal surveys) surrounding utilisation of CMI. Descriptive and comparative analyses were conducted.

Results

Half of consumers surveyed wanted to receive CMI for their prescription medicine, with spoken information preferable to written medicine information for many consumers and healthcare professionals. GPs and pharmacists remained a preferred source of medicine information for consumers, although package inserts were appealing to many among all three cohorts. Overall pharmacists were the preferred provider of CMI primarily due to their medicine expertise, accessibility and perceived availability. GPs preferred CMI dissemination through both the GP and pharmacist. Some consumers preferred GPs as the provider of medicines information because of their knowledge of the patients’ medicines and/or medical history, regularity of seeing the patient and good relationship with the patient. Common barriers to CMI provision cited included: time constraints, CMI length and perceptions that patients are not interested in receiving CMI. Facilitators to enhance provision included: strategies to increase consumer awareness, longer consultation times and counseling appointments, and improvements to pharmacy software technology and workflow.

Conclusion

Medicine information is important to consumers, whether as spoken, written or a combination of both. A tailored approach is needed to ascertain individual patient preference for delivery and scope of medicine information desired so that appropriate information is provided. The barriers of time and perceived attitudes of healthcare practitioners present challenges which may be overcome through changes to workplace practices, adoption of identified facilitators, and education about the positive benefits of CMI as a tool to engage and empower patients.

【 授权许可】

   
2014 Hamrosi et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Gibbs S, Waters WE, George CF: The benefits of prescription information leaflets (2). Br J Clin Pharmacol 1989, 28(3):345-351.
• [2]Dodds LJ: Effects of information leaflets on compliance with antibiotic therapy. Pharm J 1986, 236:48-51.
• [3]Raynor DK, Blenkinsopp A, Knapp P, Grime J, Nicolson DJ, Pollock K, Dorer G, Gilbody S, Dickinson D, Maule AJ, Spoor P: A systematic review of quantitative and qualitative research on the role and effectiveness of written information available to patients about individual medicines. Health Technol Assess 2007, 11(5):iii. 1–160
• [4]Koo M, Krass I, Aslani P: Consumer use of consumer medicine information. Jnl Pharm Prac Res 2005, 35(2):94-98.
• [5]Aslani P, Benrimoj SI, Krass I: Development and evaluation of a training program to foster the use of written drug information in community pharmacies. Part 2: Evaluation. Pharm Educ 2007, 7(2):141-149.
• [6]Aslani P, Hamrosi K, Feletto E, Knapp P, Parkinson B, Hughes J, Nissen L, Moore A, Raynor DK: Investigating Consumer Medicine Information (CMI) Report. CMI effectiveness tender. The Pharmacy Guild of Australia and Department of Health and Ageing 2010. Accessed from: http://www.guild.org.au/services-programs/research-and-development/archive---fourth-agreement/2007-08-03 webcite
• [7]Benton M, Snow K, Parr V: Evaluation of the Medicines Information for Consumer (MIC) program. Pyrmont, NSW Australia: Pharmacy Guild of Australia; 2004.
• [8]Therapeutic Goods Administration: Second Discussion Paper: Improving access to Consumer Medicine Information (CMI) and Product Information (PI). Edited by Department of Health and Ageing. Canberra: Australian Government; 2007. Government discussion paper
• [9]Hamrosi KK, Raynor DK, Aslani P: Pharmacist and general practitioner ambivalence about providing written medicine information to patients-a qualitative study. Res Social Adm Pharm 2013, 9(5):517-530.
• [10]Hamrosi KK, Aslani P, Raynor DK: Beyond needs and expectations: identifying the barriers and facilitators to written medicine information provision and use in Australia. Health Expect 2014, 17(2):220-231.
• [11]Koo M, Krass I, Aslani P: Enhancing patient education about medicines: factors influencing reading and seeking of written medicine information. Health Expect 2006, 9(2):174-187.
• [12]Therapeutic Goods Administration: Mechanisms to maintain the currency of approved Product Information (PI) and Consumer Medicine Information (CMI). Edited by Department of Health and Ageing. Canberra: Australian Government, ACT; 2013.
• [13]Government Australian: Therapeutic Goods Regulations. Edited by Department of Health and Ageing. Canberra: Federal Register of Legislative Instruments; 1990. [Part 2A- Patient Information Statutory Rules 1990 No. 394 as amended]
• [14]Australian Government: Therapeutic Goods Regulations. Schedule 12: Subregulation 9A (1) Patient Information Documents. Edited by Department of Health and Ageing. Canberra: Federal Register of Legislative Instruments; 1990. [Statutory Rules 1990 No. 394 as amended]
• [15]Pharmaceutical Society of Australia: Guidelines for Pharmacists on Providing Medicines Information to Patients. In Pharmacy Practice Handbook. PSA; 2000.
• [16]Society of Hospital Pharmacists of Australia: SHPA standards of practice for the provision of consumer medicines information by pharmacists in hospitals. Jnl Pharm Prac Res 2007, 37:56-58.
• [17]National Health and Medical Research Council: General guidelines for medical practitioners on providing information to patients. Edited by Australian Government. Canberra, Australia; 2004.
• [18]Herxheimer A: Doctor/patient dialogue - the main aims of PPIs. SCRIP 1988, 1356:4-6. Cited in Aslani, P. (1999) Use of Consumer Medicine Information by Community Pharmacists. University of Sydney Thesis, Sydney, Australia
• [19]Raynor DK, Savage I, Knapp P, Henley J: We are the experts: people with asthma talk about their medicine information needs. Patient Educ Couns 2004, 53(2):167-174.
• [20]Australian Bureau of Statistics: Population by Age and Sex, Australian States and Territories, June 2008. 2008. Accessed from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/ProductsbyReleaseDate/2DB211BA9B6E1A25CA2576860017C2F8?OpenDocument webcite
• [21]Australian Bureau of Statistics: Australian Demographic Statistics June 2008. 2008. Accessed from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3101.0Jun%202008?OpenDocument#Publications webcite
• [22]Kalton G: Introduction to survey sampling. Beverly Hills: Sage Publications; 1983.
• [23]Newnham GM, Burns WI, Snyder RD, Dowling AJ, Ranieri NF, Gray EL, McLachlan SA: Attitudes of oncology health professionals to information from the Internet and other media. Med J Aust 2005, 183(4):197-200.
• [24]Parker MH, Cartwright CM, Williams GM: Impact of specialty on attitudes of Australian medical practitioners to end-of-life decisions. Med J Aust 2008, 188(8):450-456.
• [25]Koo MM, Krass I, Aslani P: Evaluation of written medicine information: validation of the Consumer Information Rating Form. Ann Pharmacother 2007, 41(6):951-956.
• [26]Hamrosi KK, Raynor DK, Aslani P: Pharmacist, general practitioner and consumer use of written medicine information in Australia: are they on the same page? Res Social Adm Pharm 2013. In Press
• [27]Aslani P, Benrimoj S, Krass I: Development and Evaluation of a training program to foster the use of written drug information in community pharmacies- Part 1- Development. 6(1) pp 41–52. Pharm Educ 2006, 6(1):41-52.
• [28]Australian Bureau of Statistics: Education and Work, Australia May 2008. 2008. Accessed from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/allprimarymainfeatures/E2407548461DD3FCCA25767700147D96?opendocument webcite
• [29]Puspitasari HP, Aslani P, Krass I: Pharmacists’ and consumers’ viewpoints on counselling on prescription medicines in Australian community pharmacies. Int J Pharm Pract 2010, 18(4):202-208.
• [30]Sleath B, Wurst K: Patient receipt of, and preferences for receiving, antidepressant information. Int J Pharm Pract 2002, 10:235-241.
• [31]Nair K, Dolovich L, Cassels A, McCormack J, Levine M, Gray J, Mann K, Burns S: What patients want to know about their medications. Focus group study of patient and clinician perspectives. Can Fam Physician 2002, 48:104-110.
• [32]Fox S: The Social Life of Health Information. Washington DC: Pew Internet & American Life Project; 2011.
• [33]Ho CH, Ko Y, Tan ML: Patient needs and sources of drug information in Singapore: is the Internet replacing former sources? Ann Pharmacother 2009, 43(4):732-739.
• [34]Kim KY, Metzger A, Wigle PR, Choe PJ: Evaluation of online consumer medication information. Res Social Adm Pharm 2011, 7(2):202-207.
• [35]Eysenbach G, Powell J, Kuss O, Sa ER: Empirical studies assessing the quality of health information for consumers on the world wide web: a systematic review. JAMA 2002, 287(20):2691-2700.
• [36]Freeman GK, Horder JP, Howie JG, Hungin AP, Hill AP, Shah NC, Wilson A: Evolving general practice consultation in Britain: issues of length and context. Brit Med J 2002, 324(7342):880-882.
• [37]Koo M, Krass I, Aslani P: Consumer opinions on medicines information and factors affecting its use-an Australian experience. Int J Pharm Pract 2002, 10(2):107-114.
• [38]Bandesha G, Raynor DK, Teale C: Preliminary investigation of patient infromation leaflets as package inserts. Int J Pharm Pract 1996, 4:246-248.
• [39]McGrath JM: Physicians’ perspectives on communicating prescription drug information. Qual Health Res 1999, 9(6):731-745.
• [40]Ong LM, de Haes JC, Hoos AM, Lammes FB: Doctor-patient communication: a review of the literature. Soc Sci Med 1995, 40(7):903-918.
• [41]Marsden PV, Wright JD: Handbook of Survey Research. 2nd edition. Bingley, UK: Emerald Group Publishing Limited; 2010.
• [42]Hammarberg K, Setter T, Norman RJ, Holden CA, Michelmore J, Johnson L: Knowledge about factors that influence fertility among Australians of reproductive age: a population-based survey. Fertil Steril 2013, 99(2):502-507.
• [43]Yap MB, Reavley N, Jorm AF: Where would young people seek help for mental disorders and what stops them? Findings from an Australian national survey. J Affect Disord 2013, 147(1–3):255-261.