ABSTRACT
OBJECTIVE: Evaluate the distribution and quality of patient medication leaflets provided in U.S. pharmacies. DESIGN: Observational. SETTING: United States. PARTICIPANTS: 384 randomly selected community pharmacies in 44 states. INTERVENTIONS: Professional shoppers (acting as patients) presented four new prescriptions to study pharmacies. MAIN OUTCOME MEASURES: Medication leaflets obtained by shoppers were evaluated by expert and consumer raters using criteria specified in federal law mandating distribution of useful written information to 95% of individuals receiving new prescriptions by 2006. RESULTS: Leaflets were provided by pharmacies with 89% of 1,536 prescriptions presented by professional shoppers posing as patients. Leaflet quality varied: 95% of leaflets received high ratings on accuracy, but only 19% received high ratings on the specificity of directions. Fewer than 10% of all leaflets met quality criteria regarding contraindications, precautions, and how to avoid harm. One fourth of all leaflets had poor print size, according to the shoppers. CONCLUSION: Additional efforts are needed to meet federally mandated information distribution and quality goals by 2006.
Subject(s)
Community Participation/methods , Community Pharmacy Services/standards , Pamphlets , Professional Competence/standards , Atenolol/therapeutic use , Community Pharmacy Services/statistics & numerical data , Community Pharmacy Services/trends , Consumer Behavior/statistics & numerical data , Drug Utilization/classification , Drug Utilization/statistics & numerical data , Humans , Information Dissemination/methods , Program Evaluation/methods , Program Evaluation/standards , Reproducibility of Results , United States , United States Food and Drug AdministrationABSTRACT
OBJECTIVES: To develop three tools for assessing the quality of written information provided with new prescriptions in community pharmacies and to identify pharmacy, pharmacist, and patient characteristics associated with the dissemination and quality of that information. DESIGN: Observational study. Regression techniques were used to analyze the influence of pharmacy, pharmacist, and shopper (acting as patient) characteristics on outcome measures. PARTICIPANTS: Trained shoppers (acting as patients) visited 306 randomly selected pharmacies in 8 states. Each shopper presented three prescriptions, answered questions according to a standard scenario, accepted the information offered, and paid for the prescriptions. MAIN OUTCOME MEASURES: Percentage of shoppers receiving any written information; quality of written information as judged by an expert panel using explicit criteria. RESULTS: Shoppers received an information leaflet with 87% of the 918 prescriptions dispensed. Although most leaflets provided unbiased information, leaflet length and quality of information varied greatly. A majority of leaflets did not include adequate information about contraindications, precautions, and how to avoid harm. Shoppers were more likely to receive leaflets in chain pharmacies and pharmacies with more staff. Information quality also was higher in chain pharmacies. Shopper and pharmacist demographic characteristics were unrelated to the level or quality of written information after controlling for other factors. CONCLUSION: The provision of patient leaflets is becoming a routine practice in the states studied. However, most leaflets do not meet quality criteria. It is important for pharmacists to become familiar with criteria for evaluating these leaflets and to take necessary action to improve their quality.
