“A Disconnect in the Process and Understanding of Prescription Medications”
Download PDF About the AuthorMatthew 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 |
Literature ReviewPrior research has identified a multitude of topics that are relevant to prescription medication literature and the physician-patient interaction. Research analyzing pharmaceutical text types has established how language and the use of language varies across different texts within the field of pharmacology. This research identifies the keywords and lexical bundles most frequently used in four types of pharmaceutical texts: patient information leaflets, summaries of product characteristics, clinical trial protocols, and chapters from pharmacology academic textbooks (Grabowski 24). Analysis of these texts found that keywords and phrases became more simplified within the patient information leaflets and summaries of product characteristics (27). Simplification of these text types may have been for the purposes of the patient’s understanding of their prescription, in the case of the patient information leaflets, as well as for physicians and pharmacists to be able to properly understand and issue medications, in the case of the summaries of product characteristics (24). Summaries of product characteristics are included with prescription medications and are a description of the product, including its “pharmacological, chemical, pharmaceutical and toxicological properties as well as of the clinical use to which they can be put” (24). Patient information leaflets can be defined as the pamphlet that comes with each medication providing information on how to take the drug along with other important information associated with the patient, also known as a package insert (27). Regardless of the simplification of these patient information leaflets, other studies have shown that patients still have difficulty understanding these information guides due to their complexity and formatting (Prescription Labels – Consumer Reports Health). The complexity and formatting are critical to study as prior research has explored the readability of this literature and the levels of literacy required of the patients for comprehension. For example, in a study done by Wolf et al., 185 medication guides were analyzed and given both a Lexile score and a suitability score. Lexile scores are utilized as a measurement of the difficulty and complexity of written passages, while a suitability score is determined by the Suitability Assessment of Materials (SAM) instrument, which is most commonly used to evaluate the appropriateness of written healthcare information. Out of the 185 medication guides studied, only seven met the recommended lexical score that is associated with a reading difficulty of less than or equal to that of 8th grade and only one was determined to be suitable according to the SAM analysis (Wolf et al., “Usability of FDA-Approved Medication Guides” 1717). Along with this lack of understanding of their prescription information, many patients express a sense of dislike for taking medicine or medication in general (Britten et al. 1496). Most patients feel less inclined to convey their concerns or opinions of medications because they think it will infringe on the social interaction with their physician (1502). This becomes an issue that drastically affects a patient’s feeling toward their medication because they may be prescribed a medication that they do not want to take but were worried about addressing their opinions to the physician. A patient may feel less inclined to have a shot or an injection and may rather wish to take an oral medication such as a pill, but without proper communication with the physician the preference of the patient may not be taken into account. Even when a patient expresses their opinions or preferences on medication, the extent to which it manipulates the prescription the physician writes is questionable (1502). Other research has focused directly on the interactions between physicians and detailers, and the issues that arise from them. Detailers are employees of pharmaceutical companies who inform and persuade physicians to prescribe the company’s products, also known as pharmaceutical representatives (Lexchin 664). The primary issue regarding detailers is that they have a major conflict of interest. This is the result of their necessity to sell products for their company but to also provide the doctor with information and products that will actually enhance the health of the physician’s patients (664). When a detailer’s company is asking their employee to promote a specific medication, that is most likely the medication that is given to the doctors, and eventually prescribed to the patients. This process directly manipulates a physician’s prescribing habits, which may lead to a physician prescribing a drug that may not be the most specific and beneficial for a patient’s particular case (671). If a physician is being continually implored by the detailer to prescribe a medication that treats the general symptoms of an illness and the patient needs a prescription medication for specific symptoms of that illness, the physician may feel inclined to prescribe the medication that treats the general symptoms because it has been so heavily promoted by the detailer. This leaves the patient at a disadvantage. The readability of medication guides and the variability of the physician-patient interaction indicate that there is a need to improve the patient’s understanding of their prescription medications. Therefore, the aim of this study is to examine both medication guides and the physician-patient interaction through participant surveys and think-aloud protocols. |