[Drug information must be critically scrutinized. Industry's only wish: prescription from the physician to the patient]. / Läkemedelsinformationen måste granskas kritiskt. Industrins enda önskade sluteffekt: receptet från doktorn till patienten.

The purpose of drug information from the pharmaceutical industry is to increase sales. The message is often simplified, short, with emphasis on Unique Selling Points (USP). Information is often given in a pleasant environment, food is served, gifts handed out. The same information is repeated in advertising campaigns. However, the information is often incomplete and the level of evidence not discussed. The purpose of producer independent information is to give scientific facts according to the principles practiced by evidence-based medicine. This information focuses on the level of evidence of published papers but is often more lengthy, may be difficult to understand and may even be regarded as boring. There are, however, useful principles to apply when analysing the information given by the pharmaceutical industry on specific drugs. There are also several sources of independent drug information to turn to.

The effects on knowledge of the systematic education of patients with joint diseases treated with NSAIDs and diuretics.

In a randomised, controlled trial, patients with joint diseases and concomitant treatment with NSAIDs and diuretics received systematic education. The intervention group was given information by a self-conducted, interactive Kodak Photo-CD program in addition to personal drug information and non-commercial drug leaflets. Awareness of drug interactions and encouragement of self-adjustment of treatment was focused on. Control patients received conventional information. Three months after randomisation, knowledge was tested by means of a questionnaire. At 3 months there was a significant difference in attained score between the intervention group and the control group. Greater knowledge was achieved, especially on drug interaction, in the intervention group. In conclusion, less than 1 h of systematic education significantly improved patients' knowledge on essential issues of concomitant treatment with NSAIDs and diuretics. Knowledge of effects, side-effects and interactions of drugs is essential for self-adjustment of treatment. The method employed, which is standardised and produces a reproducible quantity of education, might be applicable to several other medical conditions.

Health care costs of heart failure: results from a randomised study of patient education.

BACKGROUND: Heart failure is a serious syndrome with a bad prognosis. Hospitalisation is common and readmittance rate is high; factors which influence the cost of care and treatment. Only scarce data on detailed patient materials regarding health care costs are known. AIMS: To describe in detail the health care costs for heart failure patients. METHODS: Costs for patients (n=108) who completed a randomised education trial were studied for 6 months after hospital discharge. Costs for hospital stay, out-patient visits, diagnostic tests and procedures, laboratory analyses and drug treatment were calculated. Official unit prices list used to reimburse providers of cross-boundary health services and prices for drugs in the Swedish Drug Compendium were employed. RESULTS: The total cost for a heart failure patient was approximately 20000 SEK (2564 US$, 7.80 SEK=1 US$) for 6 months. There was a 27-fold variation between patients. There was no relation between age or sex and cost. In decreasing order cost for hospitalisation was followed by costs for out-patient visits, diagnostic tests and procedures, laboratory analyses and drugs. CONCLUSION: Hospitalisation was the largest part of the total cost and there was a large inter-individual variation. Efforts to reduce the economic burden should be focused on hospitalisation. Due to skewed distribution, individual data must be considered in the analysis of the efforts.

Effects of systematic education on heart failure patients' knowledge after 6 months. A randomised, controlled trial.

BACKGROUND: Many procedures for patient education are introduced in clinical practice without proper evaluation in randomised trials. AIMS: To compare systematic nurse and pharmacist led education including an interactive Kodak Photo-CD Portfolio technique with conventional information regarding heart failure patients' knowledge. METHODS: One hundred and thirty heart failure patients discharged from hospital were randomised to receive either conventional information or additional structured education with a follow-up of 6 months. Difference in knowledge was tested by questionnaire after 6 months. RESULTS: At the end of the study there was a significant difference in the intervention group (n = 50) compared to the control group (n = 58) regarding knowledge as tested by a questionnaire. Of maximal 28 points the intervention group attained 17.2 points (mean) and the control group 14.3 points (mean), 95% confidence interval for difference 1.0-4.7 points (P = 0.0051). CONCLUSIONS: Two to 3 hours of systematic education improved heart failure patients' knowledge on essential issues. High age does not preclude the introduction of a new technique for patient education.