Related to yesterday’s observations regarding risk management, a key component of risk management is communications. The appropriate communication not only of risk, but of proper use, are essential. It is food for thought for the communications companies that provide support to pharmaceutical products.
Product marketing is more these days, than just being experienced at launching a drug – it is about crisis, it is about regulatory preparation and it is about a track record in providing support services related to the proper use of medication and the management of risk in order to maximize benefit.
I remember once hearing a story described at an FDA Advisory Committee meeting of a mother who read instructions on a medication and understood the word "oral" to mean that the medication should be applied to the ear. While the ear may not have been harmed, the child could not benefit from a medication he was supposed to swallow if it was applied to his ear. This mother suffered a lack of health literacy.
Today’s Washington Post has a small article on a recent survey that demonstrated only an intermediate health literacy standing in the United States. The most glaring part of the report was the finding that fewer than 1 in 6 adults are well equipped to understand health information properly. The report was conducted by the National Center for Education Statistics.
There is a lot of work being done on health literacy in the public and private sector and by industry. Harvard University has an entire site on health literacy studies, so has NIH, and so has Pfizer.
It would certainly be worthwhile for the communications firms charged with devising methods of product promotion took some of this work to heart in helping to fashion better and more expansive communications tools for the benefit of those seeking to convey information on the use and risk of medicine. That would involve knowing intimately this data and understanding the implications of various reading levels and how the data from studies such as this impacts marketing and safety.
As I read the e-mail from ‘Eye on FDA’ today on Health Literacy I was both amused and a little upset to see a description that, at various times since the late 40s, has been cited.
As a pharmacist back then, I can remember telling patients (and labeling) to “unwrap and insert” for suppositories and later having to revise that to “unwrap and insert in the rectum”; “these drops are for the ear infection but place on the tongue and give with water”;”instill in the left ear or instill in the right nostril”; or take with a full glass of water or don’t crush the tablets. This goes on and on. I have instructed on this issue many times when I was teaching or mentoring.
I think much of this is less a factor of Health Literacy and probably more a factor that, at the time a prescription is filled, the patient is too upset to take instructions well or is too concerned about a loved one to listen or, unfortunately, has a pharmacist or, is in an environment that precludes seeing the pharmacist first hand or doesn’t get counseling up front. Any comments on Mail Order?
These may all be necessary or unavoidable evils, but this is what needs to be addressed.
Thanks for listening!
Vincent S. Venturella, R.Ph., Ph.D.