Developing alternative over-the-counter medicine label formats: How do they compare when evaluated by consumers?

Background: In recent years, the Australian Therapeutic Goods Administration (TGA) has proposed implementing a standardized over-the-counter (OTC) medicine label. However, there were mixed consumer opinions regarding a label proposed in 2012 and limited evidence demonstrating the usability of the revised (2014) format. Objective: To develop and examine the usability of alternative OTC medicine label formats for standardization, and explore consumer perspectives on the labels. Materials and methods: Four alternative labels were developed for the exemplar medicine diclofenac. One was based on the Medicine Information label proposed by the TGA (‘Medicine Information’), one was based on the U.S. Drug Facts label (‘Drug Facts’), and two were based on suggestions proposed by consumers in the earlier needs analysis phase of this research (referred to as the ‘Medicine Facts’ and ‘Consumer Desires’ label formats). Five cohorts of 10 participants were recruited. Each cohort was assigned to user test one of the alternative labels or an existing label for a proprietary diclofenac product (which acted as a comparator) for diagnostic purposes. Each participant then provided feedback on all 5 labels. Each interview consisted of the administration of a user testing questionnaire, measuring consumers’ ability to find and understand key points of information, and a semi-structured interview exploring consumer perspectives. Results: Overall, all 4 alternative label formats supported consumers’ ability to find and understand key points. The existing comparator label was the poorer label with respect to participants’ ability to find and understand key points. Factors such as perceived usability, color, design, content, and/or content ordering impacted consumer preferences. The ‘Consumer Desires’ or ‘Drug Facts’ label formats were most often preferred by consumers for use as the standardized OTC label over the TGA proposed format. Conclusions: All alternative label formats demonstrated satisfactory usability and could be considered for use in OTC label standardization. User testing of OTC labels and consumer feedback received as part of the testing process can assist in the refinement of OTC labeling to ensure that implemented policies are evidence-based

Women’s health literacy and the complex decision-making process to use complementary medicine products in pregnancy and lactation

© 2019 The Authors Health Expectations published by John Wiley & Sons Ltd Background: Little is known about women's decision-making processes regarding using complementary medicine products (CMPs) during pregnancy or lactation. Objectives: To explore the decision-making processes of women choosing to use CMPs in pregnancy and lactation; and to investigate how women's health literacy influences their decisions. Design, setting and participants: In-depth interviews and focus group discussions were held with twenty-five pregnant and/or breastfeeding women. Data were analysed using thematic analysis. Results: Key to women's decision making was the desire to establish a CMPs safety and to receive information from a trustworthy source, preferably their most trusted health-care practitioner. Women wanted positive therapeutic relationships with health-care practitioners and to be highly involved in the decisions they made for the health of themselves and their children. Two overarching components of the decision-making process were identified: (a) women's information needs and (b) a preference for CMP use. Women collated and assessed information from other health-care practitioners, other mothers and published research during their decision-making processes. They showed a strong preference for CMP use to support their pregnancy and breastfeeding health, and that of their unborn and breastfeeding babies. Discussion and Conclusions: Complex decision-making processes to use CMPs in pregnancy and lactation were identified. The participants showed high levels of communicative and critical health literacy skills in their decision-making processes. These skills supported women's complex decision-making processes

Consumer interpretation of ramipril and clopidogrel medication risk information – Implications for risk communication strategies

Purpose: Side effects and side-effect risk information can be provided using written medicine information. However, challenges exist in effectively communicating this information to consumers. This study aimed to explore broad consumer profiles relevant to ramipril and clopidogrel side-effect risk information interpretation. Methods: Three focus groups were conducted (n=18 consumers) exploring consumer perspectives, understanding and treatment decision making in response to ramipril and clopidogrel written medicine information leaflets containing side effects and side-effect risk information. All discussions were audio recorded, transcribed verbatim, and analyzed to explore consumer profiles pertaining to side-effect risk appraisal. Results: Three consumer profiles emerged: glass half-empty, glass half-full, and middle-of-the-road consumers, highlighting the influence of perceived individual susceptibility, interpretation of side-effect risk information, and interindividual differences, on consumers’ understanding of side-effect risk information. All profiles emphasized the importance of gaining an understanding of individual side-effect risk when taking medicines. Conclusion: Written side-effect risk information is not interpreted uniformly by consumers. Consumers formulated their own construct of individual susceptibility to side effects. Health care professionals should consider how consumers interpret side-effect risk information and its impact on medication use. Existing risk communication strategies should be evaluated in light of these profiles to determine their effectiveness in conveying information

Complementary medicine products used in pregnancy and lactation and an examination of the information sources accessed pertaining to maternal health literacy: A systematic review of qualitative studies

© 2018 The Author(s). Background: The prevalence of complementary medicine use in pregnancy and lactation has been increasingly noted internationally. This systematic review aimed to determine the complementary medicine products (CMPs) used in pregnancy and/or lactation for the benefit of the mother, the pregnancy, child and/or the breastfeeding process. Additionally, it aimed to explore the resources women used, and to examine the role of maternal health literacy in this process. Methods: Seven databases were comprehensively searched to identify studies published in peer-reviewed journals (1995-2017). Relevant data were extracted and thematic analysis undertaken to identify key themes related to the review objectives. Results: A total of 4574 articles were identified; 28 qualitative studies met the inclusion criteria. Quantitative studies were removed for a separate, concurrent review. Herbal medicines were the main CMPs identified (n=21 papers) in the qualitative studies, with a smaller number examining vitamin and mineral supplements together with herbal medicines (n=3), and micronutrient supplements (n=3). Shared cultural knowledge and traditions, followed by women elders and health care professionals were the information sources most accessed by women when choosing to use CMPs. Women used CMPs for perceived physical, mental-emotional, spiritual and cultural benefits for their pregnancies, their own health, the health of their unborn or breastfeeding babies, and/or the breastfeeding process. Two over-arching motives were identified: 1) to protect themselves or their babies from adverse events; 2) to facilitate the normal physiological processes of pregnancy, birth and lactation. Decisions to use CMPs were made within the context of their own cultures, reflected in the locus of control regarding decision-making in pregnancy and lactation, and in the health literacy environment. Medical pluralism was very common and women navigated through and between different health care services and systems throughout their pregnancies and breastfeeding journeys. Conclusions: Pregnant and breastfeeding women use herbal medicines and micronutrient supplements for a variety of perceived benefits to their babies' and their own holistic health. Women access a range of CMP-related information sources with shared cultural knowledge and women elders the most frequently accessed sources, followed by HCPs. Culture influences maternal health literacy and thus women's health care choices including CMP use

Multiple Object Tracking in Urban Traffic Scenes with a Multiclass Object Detector

Multiple object tracking (MOT) in urban traffic aims to produce the trajectories of the different road users that move across the field of view with different directions and speeds and that can have varying appearances and sizes. Occlusions and interactions among the different objects are expected and common due to the nature of urban road traffic. In this work, a tracking framework employing classification label information from a deep learning detection approach is used for associating the different objects, in addition to object position and appearances. We want to investigate the performance of a modern multiclass object detector for the MOT task in traffic scenes. Results show that the object labels improve tracking performance, but that the output of object detectors are not always reliable.Comment: 13th International Symposium on Visual Computing (ISVC

Beyond needs and expectations: Identifying the barriers and facilitators to written medicine information provision and use in Australia

Purpose: This study aimed to explore peoples' needs and expectations of written medicines information (WMI), and to determine the barriers and facilitators experienced or perceived in the context of WMI provision and use. Methods: We conducted eight focus groups with 62 participants over 6weeks in late 2008 in New South Wales, Australia. Using a semi-structured topic schedule and examples of WMI from Australia and other English-speaking countries as a guide, we explored themes relevant to WMI, including participant experiences, attitudes, beliefs and expectations. Findings: Our findings suggest less than half had previously received WMI, with many unaware of its availability. Many, but not all, wanted WMI to supplement the spoken information they received but not to replace it, and it was predominantly used to facilitate informed choice, ascertain medicine suitability and review instructions. The current leaflets were considered technical and long, and a summary leaflet in addition to comprehensive information was favoured. Accurate side-effect information was the most important element that participants desired. The most common barriers to effective WMI use were time constraints and patient confidence, with participants citing empowerment, time and health-care professional (HCP)-patient relationships as important facilitators. Conclusion: The findings provide insight and understanding of peoples needs and expectations, and clarify issues associated with use and non-use of WMI. Challenges include addressing the barriers, especially of time and HCP attitudes to drive changes to workplace practices, and learning from the facilitating factors to encourage awareness and accessibility to WMI as a tool to empower patients

The State of Food Insecurity and Its Relationship with the Physical and Mental Health of the Elderly (Sanandaj, 2019)

Background and Objective: Food insecurity is defined as limited or uncertain access to adequate and healthy food in terms of nutrition or limited ability to obtain food in socially acceptable ways, which can affect the health of the elderly. The aim of this research is to investigate the state of food insecurity and the factors affecting it and its role in physical and mental health in the elderly. Methods: This cross-sectional study was conducted on 550 elderly people aged 60 years and older who referred to 10 health centers in Sanandaj, and were selected via random cluster sampling. Demographic information questionnaire, HFIAS food security questionnaire (8 questions with a score range of 0 to 24) and Goldberg General Health Questionnaire (28 questions with 4 subscales) were completed and reviewed. Findings: In this study, 324 elderly women and 224 men were evaluated, 75.6% were married and 73.6% were illiterate. The findings showed that 59.1% (325 people) of the elderly had some degree of food insecurity and severe insecurity was observed in 62 people (11.3%). Food insecurity in people with moderate to severe physical symptoms (OR=7.33), anxiety and sleep disorder (OR=8.63), functional disorder (OR=6.78), depression (OR=21.12) and in general, moderate to severe general health disorder (OR=11.85) was seen more. In addition, food insecurity, not being married, being illiterate, living alone, and low income were observed to a greater extent in women. Conclusion: The results of the study showed that the prevalence of food insecurity among the elderly in Sanandaj is significant and is related to factors such as general, physical and mental health disorders

Pharmacy practice research priorities during the COVID-19 pandemic: Recommendations of a panel of experts convened by FIP Pharmacy Practice Research Special Interest Group

Across the globe, pharmacists on the frontline continue to fight COVID-19 and its continuously evolving physical, mental, and economic consequences armed by their knowledge, professionalism, and dedication. Their need for credible scientific evidence to inform their practice has never been more urgent. Despite the exponentially increasing number of publications since the start of the pandemic, questions remain unanswered, and more are created, than have been resolved by the increasing number of publications. A panel of leading journal editors was convened by the International Pharmaceutical Federation (FIP) Pharmacy Practice Research Special Interest Group to discuss the current status of COVID-19 related research, provide their recommendations, and identify focal points for pharmacy practice, social pharmacy, and education research moving forward. Key priorities identified spanned a wide range of topics, reflecting the need for good quality research to inform practice and education. The panel insisted that a foundation in theory and use of rigorous methods should continue forming the basis of inquiry and its resultant papers, regardless of topic area. From assessing the clinical and cost effectiveness of COVID-19 therapies and vaccines to assessing different models of pharmaceutical services and education delivery, these priorities will ensure that our practice is informed by the best quality scientific evidence at this very challenging time

Enhancing provision of written medicine information in Australia: Pharmacist, general practitioner and consumer perceptions of the barriers and facilitators

Background: Written medicine information can play an important role in educating consumers about their medicines. In Australia, standardised, comprehensive written information known as Consumer Medicine Information (CMI) is available for all prescription medicines. CMI is reportedly under-utilised by general practitioners (GPs) and community pharmacists in consultations, despite consumer desire for medicine information. This study aimed to determine consumers', GPs' and community pharmacists' preferences for CMI provision and identify barriers and facilitators to its use. Method. Structured questionnaires were developed and administered to a national sample of Australian consumers (phone survey), community pharmacists and GPs (postal surveys) surrounding utilisation of CMI. Descriptive and comparative analyses were conducted. Results: Half of consumers surveyed wanted to receive CMI for their prescription medicine, with spoken information preferable to written medicine information for many consumers and healthcare professionals. GPs and pharmacists remained a preferred source of medicine information for consumers, although package inserts were appealing to many among all three cohorts. Overall pharmacists were the preferred provider of CMI primarily due to their medicine expertise, accessibility and perceived availability. GPs preferred CMI dissemination through both the GP and pharmacist. Some consumers preferred GPs as the provider of medicines information because of their knowledge of the patients' medicines and/or medical history, regularity of seeing the patient and good relationship with the patient. Common barriers to CMI provision cited included: time constraints, CMI length and perceptions that patients are not interested in receiving CMI. Facilitators to enhance provision included: strategies to increase consumer awareness, longer consultation times and counseling appointments, and improvements to pharmacy software technology and workflow. Conclusion: Medicine information is important to consumers, whether as spoken, written or a combination of both. A tailored approach is needed to ascertain individual patient preference for delivery and scope of medicine information desired so that appropriate information is provided. The barriers of time and perceived attitudes of healthcare practitioners present challenges which may be overcome through changes to workplace practices, adoption of identified facilitators, and education about the positive benefits of CMI as a tool to engage and empower patients