E-drug: Patient drug information in lesser developed countries
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[The below message had formatting problems in a earlier posting.
Apologies. HH, E-drug co-moderator]
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.
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