| · Women in pharmacy
· Complementary medicine (2)
· Medicine guides
· Accredited training
· Medicines adminstration
· Regulation
· The Society
· Onlooker (2)
Letters to the Editor
|
Medicine guides
Ambiguous and incorrect information
From Mrs P. E. Bourne,
MRPharmS
As a pharmacist with a special interest in the treatment of rheumatoid
arthritis I was keen to examine the new “medicine guides” for
medicines used in the treatment of rheumatoid arthritis, osteoarthritis
and gout published recently at www.medicines.org.uk and compare them
with the excellent medicines information that is published by the Arthritis
Research Council (ARC) for patients with RA and other inflammatory conditions.
Medicine guides are being developed as part of the Medicines Information
Project (MIP) and are described as “a new source of information
for members of the public who are looking for information about individual
medicines that is up-to-date, reliable and understandable”. The
project prides itself in providing information that is “a user-friendly
complement to the pack insert but, critically, is available for patients
to access before the prescribing decision is made”. The MIP is
working in partnership with a number of other organisations, including
the Royal Pharmaceutical Society, “with different and complementary
skill sets and a shared vision of high quality, reliable medicines information
for patients and carers”. The MIP states that medicine guides are “continuously
updated and checked by medicines information pharmacists and the manufacturers
for factual accuracy”.
On first accessing the medicines.org website and clicking on “Rheumatoid
arthritis medicine guides” the user is confronted with a page that
lists no fewer than 132 different medicines. Although it soon becomes
clear to a health professional that not all 132 medicines are different
because each medicine is listed under its generic and, in some cases,
several different brand names, to the average patient who accesses the
site this must be mind-boggling.
However, let us suppose that the rheumatologist mentions to the patient
that he is considering prescribing an anti-tumour necrosis factor agent
for him and gives him the ARC leaflets on etanercept, adalimumab and
infliximab. The patient also decides to search the internet and comes
across the medicine guides. The patient will probably want to know what
anti-TNF agents are, how they work, how they are administered and how
often, what are the contraindications, interactions, precautions and
most common side effects, and what monitoring will be required. The ARC
leaflet gives all this information in a succinct and understandable way.
The medicine guides on the other hand are wordy, ambiguous and in some
cases factually incorrect.
Take etanercept as an example. The ARC leaflet states correctly that
etanercept is given by subcutaneous injection (an injection under the
skin) once or twice a week and that the patient, their partner or other
family member, can learn how to give the injections. The medicine guide
states, incorrectly, that etanercept is an injection that is usually
given by a health care professional and that the person responsible for
giving it will make sure that the appropriate dose is given at the prescribed
times and that it will be stored by the medical team. There are many
more examples of ambiguous and incorrect information in this and other
medicine guides that I have examined.
The medicine guides appear to have been compiled by copying and pasting,
and contain many standard phrases and jargon that are not particularly
helpful to a patient trying to make treatment choices.
Were these guides really produced in collaboration with the Society and
were they really checked by medicines information pharmacists?
Pauline Bourne
Kendall,
Cumbria
| |
JOANNE SHAW, chairman, Datapharm Communications,
replies:
I am writing as chairman of Datapharm Communications Ltd, the
company which produces
medicine guides, and as one of the four co-chairmen of the Medicines
Information Project Board, which oversees the programme as a whole.
As Mrs Bourne
highlights, medicine guides are being developed to provide a comprehensive,
reliable and up-to-date source of medicines information. The content
of the guides is based on summaries of product characteristics to
ensure the information we include is accurate and consistent. They are
intended
to complement not compete with other existing sources of medicines
information such as the patient information leaflet and the ARC website,
which the
rheumatoid arthritis medicine guides link to.
The authoring and production of medicine guides involves highly committed
and qualified people, including medicine information pharmacists.
As a result we
are no strangers to lively debate on the interpretation and expression of
reference information. To ensure consistency and accuracy we work
to agreed guidelines — a
difficult but vital discipline for any project of this nature.
Our ongoing evaluation of feedback from the current medicine guides, and
the pilot work started in 2003, shows that 87 per cent of respondents find
the information
useful or very useful, and 92 per cent said they would use medicine guides
again. Ninety-six per cent of pharmacists who responded said they found the
guides very
useful or useful.
The Medicines Information Project aims to provide information that will encourage
and enable patients and the public to make informed decisions about their
own health and be more involved in treatment choices, as well as make best
use
of their medicines, by providing them with a new, structured source of information
linking medical conditions, major treatment options and individual medicines.
The information about individual medicines is delivered via the medicine
guides, with links to other sources as described above. This also includes
a link between
the medicine guide and the relevant section of the NHS Direct Online Health
Encyclopaedia
where users will find further information (for example what an anti-TNF is
and how it works). Conversely, users who begin their search for information
in the
NHS Direct Online Health Encyclopaedia will find links to individual medicine
guides using the medicine name most familiar to them — whether that is
a brand or generic name.
All the organisations supporting this project share a vision of providing
high quality, reliable and comprehensive medicines information for patients
and the
public. There is an ongoing challenge in delivering an information resource
that is comprehensive and in a format that meets the needs of each person.
We welcome
constructive input from every quarter so that we can continue to improve
medicine guides to meet our vision.
We encourage readers to review this growing set of medicines information,
in the context in which it is intended and would welcome further feedback
to medguides@medicines.org.uk
This project is a work in progress. We are working hard to develop medicine
guides for every prescription medicine by the middle of 2007. We also intend
continuously
to improve the resource, particularly the valuable feedback we receive from
users. |
|
The
Pharmaceutical Journal