Literature DB >> 19722727

Communicating the risk of side effects to patients: an evaluation of UK regulatory recommendations.

Peter Knapp1, David K Raynor, Elizabeth Woolf, Peter H Gardner, Neil Carrigan, Brian McMillan.   

Abstract

BACKGROUND: All licensed medicines in the European Union must be provided with a Patient Information Leaflet that includes a list of all known side effects. Among patients who read the leaflet, the side effects section is the most often read. A UK government regulatory publication recommends providing medicine side effect risk information in a combined format, using verbal descriptors accompanied by numerical information.
OBJECTIVES: This study, with users of an existing popular patient information website, investigates the effectiveness of presenting medicine side effect risk information in different forms.
DESIGN: Participants were randomly allocated to one of the three formats for representing risk information (verbal descriptors, e.g. 'common'; absolute frequencies, e.g. 'less than 1 in 10 people'; and a combination of verbal descriptors and frequency bands, e.g. 'common (affects less than 1 in 10 people)'.
METHODS: Participants (n = 187) were recruited from users of the Cancer Research UK patient information website. They were asked to imagine that they had to take a cancer treatment (tamoxifen), estimate the risks of four side effects occurring, and complete Likert scales relating to their satisfaction with the information supplied and perceived likelihood of various outcomes.
RESULTS: Those in the absolute frequency format demonstrated greater accuracy in estimating the likelihood of having two of four side effects than the other two formats. They were also more accurate at estimating the likelihood of themselves or the average person having any side effect from taking tamoxifen. Participants in the absolute frequency format rated the risk to health from tamoxifen as lower than those in the other two formats, were more satisfied with the information they received than those in the verbal format, and felt there would be less impact of the information on tamoxifen use than those in the combined format.
CONCLUSIONS: These findings fail to confirm that the recommended use of combined descriptors for medicine side effects is unequivocally superior to absolute frequency alone. They also add weight to the growing body of research highlighting the deficiencies in using verbal descriptors for conveying side effect risk, and the strength of using absolute frequency descriptors.

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Year:  2009        PMID: 19722727     DOI: 10.2165/11316570-000000000-00000

Source DB:  PubMed          Journal:  Drug Saf        ISSN: 0114-5916            Impact factor:   5.606


  12 in total

Review 1.  The role and value of written information for patients about individual medicines: a systematic review.

Authors:  Janet Grime; Alison Blenkinsopp; David K Raynor; Kristian Pollock; Peter Knapp
Journal:  Health Expect       Date:  2007-09       Impact factor: 3.377

2.  Ask the pharmacist: an analysis of online drug information services.

Authors:  Erin R Holmes; Shane P Desselle; Danielle M Nath; Jason J Markuss
Journal:  Ann Pharmacother       Date:  2005-02-15       Impact factor: 3.154

3.  Influences, usage, and outcomes of Internet health information searching: multivariate results from the Pew surveys.

Authors:  Ronald E Rice
Journal:  Int J Med Inform       Date:  2005-08-24       Impact factor: 4.046

4.  Proposed changes for nurse education in England (UK) as a result of the Darzi report (DoH, 2008a) Health Quality Care for All--NHS next stage review final report: some initial observations.

Authors:  Karen Holland
Journal:  Nurse Educ Pract       Date:  2008-09       Impact factor: 2.281

5.  How much information about adverse effects of medication do patients want from physicians?

Authors:  D K Ziegler; M C Mosier; M Buenaver; K Okuyemi
Journal:  Arch Intern Med       Date:  2001-03-12

6.  Patients' perceptions of information received about medication prescribed for bipolar disorder: implications for informed choice.

Authors:  Richard Bowskill; Jane Clatworthy; Rhian Parham; Tim Rank; Rob Horne
Journal:  J Affect Disord       Date:  2006-12-15       Impact factor: 4.839

7.  Provision of information about drug side-effects to patients.

Authors:  D C Berry; P Knapp; D K Raynor
Journal:  Lancet       Date:  2002-03-09       Impact factor: 79.321

8.  Comparison of two methods of presenting risk information to patients about the side effects of medicines.

Authors:  P Knapp; D K Raynor; D C Berry
Journal:  Qual Saf Health Care       Date:  2004-06

Review 9.  Patients' understanding of risk associated with medication use: impact of European Commission guidelines and other risk scales.

Authors:  Dianne C Berry; D K Raynor; Peter Knapp; Elisabetta Bersellini
Journal:  Drug Saf       Date:  2003       Impact factor: 5.606

10.  Adequacy of patient information on adverse effects: an assessment of patient information leaflets in the UK.

Authors:  Neil Carrigan; D K Raynor; Peter Knapp
Journal:  Drug Saf       Date:  2008       Impact factor: 5.606

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  19 in total

1.  Comprehension of the description of side effects in drug information leaflets: a survey of doctors, pharmacists and lawyers.

Authors:  Andreas Ziegler; Anka Hadlak; Steffi Mehlbeer; Inke R König
Journal:  Dtsch Arztebl Int       Date:  2013-10-04       Impact factor: 5.594

2.  Combined verbal and numerical expressions increase perceived risk of medicine side-effects: a randomized controlled trial of EMA recommendations.

Authors:  Peter Knapp; Peter H Gardner; Elizabeth Woolf
Journal:  Health Expect       Date:  2015-01-26       Impact factor: 3.377

Review 3.  Risk as an attribute in discrete choice experiments: a systematic review of the literature.

Authors:  Mark Harrison; Dan Rigby; Caroline Vass; Terry Flynn; Jordan Louviere; Katherine Payne
Journal:  Patient       Date:  2014       Impact factor: 3.883

4.  Effect of Communication Style on Perceptions of Medication Side Effect Risk among Pharmacy Students.

Authors:  Ruta V Sawant; Collin R Beatty; Sujit S Sansgiry
Journal:  Am J Pharm Educ       Date:  2016-10-25       Impact factor: 2.047

5.  Factors influencing subjects' comprehension of a set of medicine package inserts.

Authors:  Carla Pires; Marina Vigário; Afonso Cavaco
Journal:  Int J Clin Pharm       Date:  2016-04-23

Review 6.  Medication Risk Communication in Rheumatology: Where Are We and Where Do We Go from Here?

Authors:  Susan J Blalock
Journal:  Curr Rheumatol Rep       Date:  2017-02       Impact factor: 4.592

7.  Positive Attribute Framing Increases COVID-19 Booster Vaccine Intention for Unfamiliar Vaccines.

Authors:  Kirsten Barnes; Ben Colagiuri
Journal:  Vaccines (Basel)       Date:  2022-06-16

8.  The Effect of Including Quantitative Information on Multiple Endpoints in Direct-to-Consumer Prescription Drug Television Advertisements.

Authors:  Helen W Sullivan; Amie C O'Donoghue; Molly Lynch; Mihaela Johnson; Christine Davis; Douglas J Rupert
Journal:  Med Decis Making       Date:  2019-10-04       Impact factor: 2.583

9.  Sharing health data for better outcomes on PatientsLikeMe.

Authors:  Paul Wicks; Michael Massagli; Jeana Frost; Catherine Brownstein; Sally Okun; Timothy Vaughan; Richard Bradley; James Heywood
Journal:  J Med Internet Res       Date:  2010-06-14       Impact factor: 5.428

10.  Visual images of prescription drug benefits in direct-to-consumer television advertisements.

Authors:  Helen W Sullivan; Amie C O'Donoghue; Molly Lynch; Mihaela Johnson; Christine Davis; Jacqueline B Amoozegar; Douglas J Rupert
Journal:  Patient Educ Couns       Date:  2021-02-13
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