E-drug: Patient drug information in lesser developed countries
---------------------------------------------
Dear E-druggers,
To complete my post-graduate program Master of Public Health at the
Netherlands School of Public Health, I am currently doing an in depth
review and
analysis of the role of written materials/patient package inserts or visual
aids in
general play or could play in communicating drug information to patients in
lesser developed countries.
It is well known that in many lesser developed countries only a minority of
drugs
is taken with prescription (see for example Haak 1988a). Many drug
treatments
can be classified as "self-medication". In these situations several other
factors
than effectivity and safety of the drug determine which treatment is taken
by
the patient, e.g. cultural beliefs, disease perception, economical reasons
etc.,
etc. (see for example Haak 1988a and Haak 1988b). Even when the drug is
prescribed by a physician, compliance and correct use is highly dependent
on
what patients understand and remember of the information health
professional
give them. Studies have shown that patients only remember a fraction of
what
doctors tell them and that this can be improved by providing
written/printed
materials (see for example Houts 1998).
It is clear that illiteracy is a serious problem in this respect (see for
example
Morgan 1993). The IALS study (IALS 1997) has shown that even in many
highly industrialised countries roughly 25% of the population has very low
literacy skills. Although I have no figures of lesser developed countries,
it�s likely
that the problem of illiteracy is in general much higher in these
countries.
The emphasis of my study is on how to deal with illiteracy and the social
and
cultural context of drug use when providing drug information for patients
in the
settings of lesser developed countries. I want to see whether (despite all
difficulties) written/printed materials and visual aids can be promoted as
a
underestimated tool to improve rational drug use in these lesser countries.
A
very interesting publication in this respect is that of Ngoh (1997).
Therefore, I would like to collect as much experiences as possible of
programs,
studies, projects etc., etc. that are working or have been working on the
provision of drug information to patients in lesser developed countries. If
you
know of such initiatives I would be very grateful if you could let me know.
Also
when you know other relevant information (articles, names etc), I would be
very
pleased if you contact me.
Furthermore, I would very much like to hear your opinions on this subject.
Is
there a role for written/printed materials in improving rational drug use
in lesser
developed countries?
Best regards,
Frans van Zoest, Msc
Netherlands School of Public Health
Admiraal Helfrichlaan 1
3527 KV Utrecht
tel.: +31-30-2913232
fax: +31-30-2913242
fvanzoest@nsph.nl
Haak H. Pharmaceuticals in two Brazilian villages: lay practices and
perceptions.
Social Science and Medicine 1988a;27:1415-1427.
Haak H, Hardon A.P. Indigenised pharmaceuticals in two Brazilian villages:
lay
practices and perceptions. Lancet 1988b;620-621.
Highlights from the second report of the International Adult Literacy
Survey:
Literacy skills or the knowledge society. 1997;1-9.
Houts PS, Bachrach R, Witmer JT, Tringali CA, Bucher JA, Localio RA. Using
pictographs to enhance recall of spoken medical instructions. Patient
Education
and Counseling 1998;35:83-88.
Morgan PP. Illiteracy can have major impact on patients' understanding of
health
care information. CMAJ 1993;148:1196-1197.
Ngogh LN, Shepherd MD. Design, development, and evaluation of visual aids
for
communicating prescription drug instructions to nonliterate patients in
rural
Cameroon. Patient Education and Counseling 1997;30:257-270.
--
Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.