Patients’ use of information about medicine side effects in relation to experiences of suspected adverse drug reactions

Background Adverse drug reactions (ADRs) are common, and information about medicines is increasingly widely available to the public. However, relatively little work has explored how people use medicines information to help them assess symptoms that may be suspected ADRs. Objective Our objective was to determine how patients use patient information leaflets (PILs) or other medicines information sources and whether information use differs depending on experiences of suspected ADRs. Method This was a cross-sectional survey conducted in six National Health Service (NHS) hospitals in North West England involving medical in-patients taking at least two regular medicines prior to admission. The survey was administered via a questionnaire and covered use of the PIL and other medicines information sources, perceived knowledge about medicines risks/ADRs, experiences of suspected ADRs, plus demographic information. Results Of the 1,218 respondents to the survey, 18.8 % never read the PIL, whilst 6.5 % only do so if something unexpected happens. Educational level was related to perceived knowledge about medicines risks, but not to reading the PIL or seeking further information about medicines risks. Over half the respondents (56.0 %) never sought more information about possible side effects of medicines. A total of 57.2 % claimed they had experienced a suspected ADR. Of these 85.9 % were either very sure or fairly sure this was a reaction to a medicine. Over half of those experiencing a suspected ADR (53.8 %) had read the PIL, of whom 36.2 % did so before the suspected ADR occurred, the remainder afterwards. Reading the PIL helped 84.8 % of these respondents to decide they had experienced an ADR. Educational level, general knowledge of medicines risks and number of regular medicines used all increased the likelihood of experiencing an ADR. Conclusion More patients should be encouraged to read the PIL supplied with medicines. The results support the view that most patients feel knowledgeable about medicines risks and suspected ADRs and value information about side effects, but that reading about side effects in PILs or other medicines information sources does not lead to experiences of suspected ADRs

The effect of perceived forgetfulness on quality of life in older adults: a qualitative review

Background Approximately 50% of older individuals perceive themselves as being forgetful. Objective The objective of this review is to get an overview of previous research on the relation between perceived forgetfulness (in the absence of objective memory deficit) and quality of life in older individuals. Findings in previous research might be a starting point for further research and possible future interventions. Methods Scientific papers that investigated the relation between subjective memory complaints and quality of life were searched. Two independent raters scored the articles on their methodology. The methodological quality was taken into account when conclusions were drawn. Results The literature search resulted in 682 articles, of which five studies met the inclusion criteria. Although the five studies differed in their methodology, the findings of the methodologically adequate studies show a relation between memory complaints and a diminished quality of life in the elderly. Conclusions The negative impact that subjective memory complaints can have on quality of life makes it important to acknowledge forgetfulness as a serious issue in the life of older individuals. However, more research is needed to explore the relationship between subjective memory complaints and quality of life, also with regard to the influence of depression and objective memory performance

Parent-completed scales for measuring seizure severity and severity of side-effects of antiepileptic drugs in childhood epilepsy: development and psychometric analysis.

We have developed two outcome measures for childhood epilepsy: a seizure severity (SS) scale and a side-effects (SE) scale. Both scales have been designed for completion by parents. The scales were tested in two pilot phases and the results of this stepwise analysis are described here. The final scales' psychometric properties were assessed in a group of 80 children with active epilepsy, representative of the population at whom the scales were aimed: children with chronic epilepsy, aged 4-16 years, including all seizure types and epilepsies, as well as children with neurological comorbidity. The SS scale and SE scale showed good internal consistency and test-retest stability. Although there was a significant positive correlation between the SS scale and the SE scale, this was low, indicating that the scales measure a different clinical trait. The SE scale consisted of two subscales: a Toxic subscale, measuring the severity of dose-related side-effects, and a Chronic subscale, measuring the severity of long-term behavioural and cognitive side-effects. These subscales for side-effects showed a high correlation and can be used as a joint scale. These scales have the potential to improve outcome assessment in childhood epilepsy and they can be used to assess important aspects of quality of life in this population

On the massive stellar population of the Super Star Cluster Westerlund 1

We present new spectroscopic and photometric observations of the young Galactic open cluster Westerlund 1 (Wd 1) that reveal a unique population of massive evolved stars. We identify ~200 cluster members and present spectroscopic classifications for ~25% of these. We find that all stars so classified are unambiguously post-Main Sequence objects, consistent with an apparent lack of an identifiable Main Sequence in our photometric data to V~20. We are able to identify rich populations of Wolf Rayet stars, OB supergiants and short lived transitional objects. Of these, the latter group consists of both hot (Luminous Blue Variable and extreme B supergiants) and cool (Yellow Hypergiant and Red Supergiant) objects - we find that half the known Galactic population of YHGs resides within Wd1. We obtain a mean V-M_V ~25 mag from the cluster Yellow Hypergiants, implying a Main Sequence turnoff at or below M_V =-5 (O7 V or later). Based solely on the masses inferred for the 53 spectroscopically classified stars, we determine an absolute minimum mass of \~1.5 x 10^3 Msun for Wd 1. However, considering the complete photometrically and spectroscopically selected cluster population and adopting a Kroupa IMF we infer a likely mass for Wd 1 of ~10^5 Msun, noting that inevitable source confusion and incompleteness are likely to render this an underestimate. As such, Wd 1 is the most massive compact young cluster yet identified in the Local Group, with a mass exceeding that of Galactic Centre clusters such as the Arches and Quintuplet. Indeed, the luminosity, inferred mass and compact nature of Wd 1 are comparable with those of Super Star Clusters - previously identified only in external galaxies - and is consistent with expectations for a Globular Cluster progenitor.Comment: A&A in press, 24 pages with 19 figures. For full resolution version see http://www.edpsciences.org/articles/aa/pdf/press-releases/PRAA200506.pdf (now correct url