“A Disconnect in the Process and Understanding of Prescription Medications”

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About the Author

Matthew White is currently an undergraduate in the Biochemistry Department at Saint Mary’s College of California. He is an aspiring physician with interests in both clinical medicine and biomedical research.

Contents

Introduction

Literature Review

Methodology

Results

Conclusion

References

Methodology

Research Design

Through the research conducted in this study, two main questions were addressed:

1. How are communication and literature about prescription medication conveyed from doctors to patients?
2. How aware are patients of the justification for their prescription medications and the effects of them?

Data for this study was gathered via the distribution of a survey and through think-aloud protocol sessions.  The surveys were distributed to twenty individuals and consisted of the following questions:

1. What is your opinion of prescription medications in general (Like or Dislike)? Why?
2. Have you understood the purpose of your past prescription medications?
3. Were you aware of the risks of your past prescription medications while taking them?
4. Have you ever refused to take a medication due to its risks?
5. Did the physician, or nurse via the physician’s orders, explain the reasoning behind why they were prescribing that medication?
6. Does the physician usually ask for your opinion regarding your openness to take certain kinds of prescription medications and do you think your opinion is considered by the physician?

For the think-aloud protocol sessions, three groups of four individuals were gathered to discuss their views and opinions of a package insert (Medication Guide) for Advair HFA, “an oral inhalation medication for treatment of asthma in patients aged 12 years and older” (Center for Drug Evaluation and Research).  This specific medication guide was chosen because Advair is a commonly prescribed medication for asthma, a lung disease that affects approximately 25 million people in the United States alone (Centers for Disease Control and Prevention). Furthermore, this medication guide was selected as the age range of the participants in this study corresponded well with the age of patients that are afflicted with asthma and therefore prescribed this medication. In these think-aloud protocol sessions, the participants were asked the following questions:

1. Are you familiar with medication guides?
2. How often do you read the medication guide that comes with your prescribed medication?
3. Did you read this entire medication guide?
4. Did it make sense? If so, why? If not, what aspects were confusing?
5. Is the language and terminology understandable?
6. Does the formatting make it easier to read?
7. Are the potential risks and effects of this drug clear and understandable?
8. At what point do you think the risks outweigh the benefit of the medication?

While there is an inherent limitation due to the small sample size of participants, this was intentional as the focus of the study is based on audience experience.  Both the surveys and the think-aloud protocol sessions were conducted in March 2017.  All participants of the study were 18- to 22-year-old individuals varying in gender and ethnicity and studying at a small liberal arts college.  This study was conducted under existing IRB approval in accordance with institutional policy.  A letter of consent was administered prior to the participation of any individual in the surveys and the think-aloud protocol sessions.  In all forms of data collection, consent was for the purposes of being able to use and analyze the information and data found during the research.  While participants of the study remained anonymous during data collection, participants consented to the use of their biographical information, which is noted in the data.  Subjects’ participation was voluntary, and individuals could choose to withdraw from the study at any time.

Data Analysis Procedures

Analysis of the data gathered in the surveys was based strictly on audience experience and the commonalities observed in the participant responses to their views and understanding of prescription medications, as well as their recollection of interactions with their physician. In addition, analysis of the data gathered in the think-aloud protocol sessions was rooted in Rhetorical Genre Theory. Rhetorical genre studies support the examination of a genre by analyzing the scene and situation in which the genre is used, the features of the genre, and how those features mediate the participant’s interactions with the genre (Bawarshi et al. 193).  Within this study, the genre analyzed was medication guides, and specifically the medication guide for Advair HFA. The scene and situation of this genre was analyzed in the think-aloud protocol sessions through questions about how the participants used the guide.  Features of this genre were explored through the think-aloud protocol sessions which analyzed the structure, language, and complexity of this medication guide. In addition, these think-aloud protocols were performed in order to identify how participants interact with and respond to the medication guide due to its distinct features.