Written medicines information is an important part of consumer education, with the interpretation of this information dependent on adequate consumer health literacy. This form of education is especially important in an acute care setting where patients may be discharged from hospital on a number of new medicines, making it difficult to retain all necessary information without support.
Low health literacy in consumers is common, impedes the ability of consumers to apply written medicines information, and is associated with poorer health outcomes. The effectiveness of medicines information resources not only relies on consumers reading, understanding and applying the information, but also on the accessibility of information, usually through provision of the information by healthcare professionals.
Evidence suggests that there may be numerous barriers to the effectiveness of standard Australian Consumer Medicines Information (CMI) resources, although evidence guiding improvements in this area is limited. As a result, a study was developed to determine whether redesigning these resources could improve provision of written medicines information to consumers by healthcare professionals, and the readability of written medicines information by consumers
An initial process of stakeholder engagement and written medicines information redesign was undertaken. Stakeholders included consumers in addition to other healthcare, legal and publishing professionals who provided input through multiple rounds of feedback on templates to be used. The redesign process focused on developing concise and targeted leaflets that highlighted important safety and efficacy messages in consumer-friendly language and formatting. While standard CMIs are brand-specific, the redesigned medicines information leaflets (MILs) were based on generic medicines.
Following redesign of CMIs into MILs, a survey was distributed to healthcare professionals working in an acute tertiary referral hospital, which compared the redesigned MILs with standard CMIs. Survey questions used five-point Likert scales and asked healthcare professionals to indicate preferences for written medicines information formatting and content inclusion. Questions determined the perceptions of healthcare professionals, including their willingness to provide written medicines information, likelihood of consumers to read the information, and comprehensiveness of content in MILs compared with CMIs. In total, 60 healthcare professionals participated in the survey, including 10 pharmacists, 15 doctors and 35 nurses.
Results found that healthcare professionals considered that the reduced document length of MILs would make them significantly more likely (P <0.0001) to provide these to consumers compared with the provision of CMIs. In addition, healthcare professionals also considered that once provided to patients, MILs would also be significantly more likely to be read compared with CMIs (P <0.0001), and all believed that consumers would find MILs easier to read than CMIs. Although only 41% of respondents had previously provided a CMI to a consumer, all agreed or strongly agreed that providing written medicines information was important. Furthermore, almost three-quarters of participants felt more confident using MILs to deliver written medicines information compared with CMIs.
Nine participants identified some potential content deficiencies with the redesigned MILs, which were a result of the reduction in document length and included lack of storage and disposal information. The excluded information was specific to brands and so was not appropriate to include in MILs, which had been designed to be generic-based.
Despite best practice recommendations, this study indicates a lack of understanding of the importance of written medicines information resources among healthcare professionals in acute hospitals, and a potential deficiency in the provision of written medicines information to consumers. Redesigning medicines information has the potential to increase the provision of written medicines information to consumers, and may improve the likelihood of consumers reading and understanding the information — both of which are key to effective medicines management by the patient following hospital discharge. Consideration of a patient’s health literacy and level of engagement in their own care is important when determining how medicines education is to be delivered, whether written medicines information is suitable or not, and if it is suitable, what formats would be most effective.
Clinical practice improvement coordinator
Sir Charles Gairdner Hospital, Perth, Western Australia
 Delfante B, Jackson C, Nicotra C et al. Improving the accuracy of medication history through better utilisation of patient’s own medicines. Paper published by University of Western Australia. Available at: http://www.watag.org.au/wamsg/docs/2016/10.%20Improving%20the%20Accuracy%20of%20Medication%20History%20Through%20Better%20Utilisation%20of%20Patients%20Own%20Medications.pdf (accessed October 2017)