Generic medicines: perceptions of consumers in Melbourne,Australia

Objective The objective of this study was to explore consumers' perceptions and opinions of generic medicines and to identify barriers to their use of generic medicines. Method A qualitative approach was used. A purposive sample of consumers, aged 22–80 years, living in the Melbourne, Australia, metropolitan area were interviewed using a semi‐structured interview guide. Key findings Sixteen consumers were interviewed. Thematic content analysis of the interviews identified four major themes: knowledge about generic medicines, acceptance of generics, non‐acceptance of generics, and education needs pertaining to generic medicine use. In terms of knowledge, some consumers were not familiar with the term ‘generic medicines’, but were more familiar with the term ‘cheaper brand of medicine’. The major reason for acceptance of generic medicines among the consumers interviewed was cost. Positive encouragement from the healthcare providers was seen to influence generic medicine uptake by consumers. The major barriers to acceptance included influence from medical practitioners, side‐effects from generic brands, and confusion that may arise from using different brands. To encourage future uptake of generics by consumers, some of the respondents recommended that education strategies be implemented by healthcare practitioners and governmental agencies to educate people on the safety and efficacy of generic medicines. Conclusions This study indicated that consumers interviewed generally had positive attitudes towards the use of generic medicines. The findings also suggest that direct patient education by the healthcare providers on issues relating to safety and efficacy of generic medicines could further enhance their uptake.     

Evaluating the frequency,consumers’ motivation and perception of online medicinal,herbal, and health products purchase safety in Saudi Arabia

ObjectivesPurchasing medicinal products from the internet has become more popular in the last three decades. Understanding consumers’ use and perception of the safety of medicinal products obtained online is essential. Therefore, this study aims to evaluate the extent of medicines purchased from the internet in Saudi Arabia, types of products, sources of information, the satisfaction, the motivational factors, and estimate consumers’ vigilance and tendency to report ADRs if occurred.DesignA prospective cross-sectional study using a custom-designed questionnaire was conducted among community adults in Saudi Arabia, age ≥ 18.SettingEvaluation of community subjects' perception towards buying medicinal products was done through the internet in Saudi Arabia from 1st July 2020 until the end of August 2020.Main outcome measure(s)The main outcome of the study was purchasing medicinal products from the internet (Yes, No).ResultsOverall, 36% of the study participants (n = 643) have ever bought medicinal products from the internet (Table 2). Of those, the most obtained was herbal medicine, supplements, or cosmetics (61.3%). Motivational factors towards purchasing medicinal products from the internet were mostly positive, with the most commonly reported agreed motivational factors were lower cost (55.7%), easy online access (54.1%), a wide variety of products (52.6%), and more privacy (43.6%). Around 60.4% of participants believed that buying medicinal products from the internet can be safe. The most perceived risk was the difficulty of distinguishing between registered online pharmacies and other unlicensed commercial websites, with only 32.7% of the participants distinguishing between registered and unlicensed commercial websites.ConclusionsThis study sheds light on the consumers’ use and perception of the safety and risks of medicinal products purchased from the internet. The study findings noticeably describe the great need to increase safety awareness about obtaining medicinal products from the internet among the Saudi community.     

Adolescents' perceptions of the internet as a health information source

The internet offers young people easy and anonymous access to information about health and medicines A series of focus groups with United Kingdom school students explored their perceptions of the internet as a health information source Less than one‐third of the students had looked for health information online; those who did were as likely to look for information about a family member's illness as their own health concerns (including diet/exercise, sexual health) Most health information seekers had used a search engine for their query, and their success was determined by their skill at evaluating the search results that they received There are opportunities for educational interventions through schools and pharmacies to help young adults to optimise their use of the internet for health information     

Concordance-based adherence support service delivery: consumer perspectives

Objectives: To explore consumers’ attitudes towards, and expectations of, adherence support services in primary health care, specifically in community pharmacy; and to explore consumers’ attitudes towards the concept of concordance. Setting: An exploratory qualitative study conducted in Metropolitan Sydney, Australia. Method: Three focus group discussions with consumers on chronic therapy (n = 22) and two focus groups with consumer representatives (n = 15) were conducted in 2002. Consumer representatives were peer educators volunteering in an association which promotes quality use of medicines among elderly patients. All discussions were audio-taped, transcribed verbatim and thematically content analysed. Main outcome measures: Consumers’ experiences with adherence support services delivered by general practitioners and pharmacists, their expectations towards general practitioners’ and pharmacists’ role in adherence support; and attitudes towards concordance in consultations. Results: Participants expected an increased provision of medicine information and a reduction in the number of medications taken as the main strategies to promote adherence. They believed that once understandable information had been delivered, it was their responsibility to take their medications as prescribed. Yet participants frequently complained about the information received, especially from doctors. Only a subgroup of participants expected pharmacists to be involved in adherence support services. These participants generally relied on pharmacists for medicine information and were satisfied with the communication process when interacting with the pharmacists. All participants were positive about concordance, because they valued two-way communication and increased consideration of their needs and beliefs by healthcare professionals. However, they were hesitant about being involved in a shared treatment decision-making process. Many participants focused on concordance with doctors and identified barriers to the establishment of concordance: time pressures, financial constraints, the gap of competence and power between patients and doctors. Conclusions: Pharmacists should consider consumers’ needs for information and establishing concordance, as well as their expectations of the pharmacy profession, in delivering concordance based adherence support services. Given participants’ high demand for medicine information, an opportunity might exist for pharmacists to influence consumers’ expectations by offering information which is tailored towards their needs.     

Design and comprehensibility of over-the-counter product labels and leaflets: a narrative review

Background Over-the-counter medicines must be supplied with appropriate, user-friendly medicine information to satisfactorily support consumer self-management and safe use. Product labels and written medicine information leaflets are highly accessible over-the-counter medicine information sources for consumers. Factors such as comprehensibility and design underpin the usefulness of over-the-counter labels and leaflets and should be further examined to better inform future optimisation strategies. Aim of the review To undertake an in-depth exploration of studies that have evaluated design and/or comprehensibility of over-the-counter labels and written medicine information leaflets Methods Database searches were performed using Medline, Embase, International Pharmaceutical Abstracts and PubMed. Studies exploring over-the-counter medicine label and/or leaflet comprehensibility and/or design were identified. Additional author and reference list searches were performed to identify studies which met the inclusion criteria and key terms. Results A total of 35 studies were included in the review, which explored OTC medicine information design and/or comprehensibility via researcher evaluation alone (n = 8) or with consumers (n = 27). Researcher-determined over-the-counter written medicine information leaflet readability (n = 4) has highlighted suboptimal readability, with few studies evaluating over-the-counter leaflet performance using the gold standard method of ‘user testing’ with consumers (n = 2). Variable over-the-counter label comprehensibility was identified in consumer studies, ranging from satisfactory understanding to considerable misunderstanding. The review findings indicate that consumer outcomes were influenced by information design, where implementation of good design principles generally improved over-the-counter label and leaflet performance. Significant diversity existed in study design aspects such as sampling frames, sample sizes and tools used to evaluate over-the-counter medicine information, which hindered the ability to adequately compare various study aspects and findings. Conclusion A wide spectrum of consumer understanding of over-the-counter medicine labels is evident in the literature, with limited studies examining over-the-counter written medicine information leaflet comprehensibility with consumers. The application of good information design principles in over-the-counter labels and leaflets contribute to improved performance. Well-designed consumer studies are needed to ascertain and optimise over-the-counter label and leaflet performance.     

An evaluation of consumers’ knowledge, perceptions and attitudes regarding generic medicines in Auckland

Objectives The aim of this project was to evaluate the perceptions, knowledge and attitudes regarding generic medicines. Methods A cross-sectional study, with self administered questionnaires, was conducted to survey consumers visiting pharmacies in four regions of Auckland (North Shore, Waitakere, Central Auckland and South Auckland). Through stratified random sampling, approximately 10% of pharmacies from each region were selected, which turn out to be 30 pharmacies. Every alternate customer coming to the pharmacy, who was eligible to participate in the study, was asked by the researchers to complete the questionnaire. Results A total of 441 questionnaires were included in the analysis. Different response rates were obtained in different regions of Auckland. Of all respondents, 51.6% had previous knowledge of generic medicines. Pharmacists were the main source of information regarding generic medicines followed by doctors and media. A higher level of education had a direct relationship with having correct knowledge of generics (P = .002). Attitude of participants toward the use of generic medicines was determined by their knowledge of generics, whether it was recommended by a pharmacist and their type of illness. Participants were more prepared to change to a generic for a minor illness (79%) than for a major illness (58.7%). Those who had better knowledge were more likely than those with poor knowledge to say they would to use a generic in major illness (P = .001) as well as minor illness (P < .0001). Previous positive experiences with generics also determined consumers’ willingness to use generics. Conclusion Many consumers have misconceptions regarding generic medicines. Having knowledge about generics and the advice by doctors and pharmacists are key indicators to improve the quality use of generic medicines.     

Group interviews with people taking long‐term medication: comparing the perspectives of people with arthritis,respiratory disease and mental health problems

Objective — To examine experiences of medicine use, advice and support from the perspectives of people taking medicines long term for arthritis, respiratory disease and mental health problems. Method — Twelve group interviews were conducted, four with each of the three chronic illness groups. Setting — Interviews were arranged through national and local voluntary organisations and conducted as part of their regular meetings. Key findings — The most prominent issue for all the Arthritis Care groups was information about side effects. People discussed the benefits of having this information and the reasons they believed that it was not generally provided. People with respiratory disease described difficulties of obtaining information as a problem in the operation of the health service in Britain, where participants may or may not find out about different products by chance. In all these discussions there were examples of how people used their regular group meetings to inform each other. For people with mental health problems, participation in decisions concerning medicines and the attitudes of health professionals were the most prominent issues. Members of all groups, across all chronic illnesses, claimed that adequate information was not shared with them during consultations with professionals. However, different perspectives of involvement in decision‐making regarding therapy were distinguishable. Pharmacy services did not feature prominently in any of the group discussions. Conclusion — The study revealed differences between the illness groups in the emphasis participants placed on different issues. However, there were also common concerns, in particular relating to obtaining information and the attitudes of professionals. While pharmacy services were not prominent in discussions, a range of unmet needs concerning medicines were identified. This indicates that opportunities exist for pharmacists to provide more responsive services that would be valued by people taking long‐term medication.     

Development and evaluation of a survey tool to explore patients' perceptions of their prescribed drugs and their need for drug information

Objective — To explore the effect of providing information about their prescribed drugs on patients' perceptions and use of the drugs. Method — A survey tool was administered to 501 general medical patients in their own homes during a trial to reduce discrepancies between supplies of hospital prescribed drugs and those received in the community following hospital discharge. The patient sample was randomly recruited into two cohorts: 264 in the intervention group (given information regarding drugs prescribed on discharge from hospital to take to their community pharmacy) and 237 in the comparison group. Responses to the survey were explored to assess any effects on patients of providing such information. Setting — Domiciliary visits to general medical patients in East London. Key findings — The survey tool was subjected to factor analysis and reliability testing. Principal components analysis (PCA) was used to extract five factors that described an intrinsic desire for information, perceived impact of the illness, perceived utility of medicines, anxiety about illness and worry about changes to medicines. Internal consistency was good, ranging from 0.8 to 0.91 (Cronbach's coefficient alpha). Interconstruct relationships between the scales, patient demographics and the two cohorts were explored. The findings indicated that the degree of patient empowerment is related to two constructs: “intrinsic desire for information” and “worry about changes to medicines.” Patients who expressed a low degree of worry about changes and a high desire for information about their drugs seemed less worried and more empowered when given additional information. Conversely, those who expressed worries about changes in their medicines and did not want information about their medicines (were happy knowing little) seemed more worried and less empowered when given additional information about those changes. Conclusion — Further exploration of relationships between patient perceptions and information provision is needed to influence appropriately the development of pharmaceutical care between hospital and community.     

Educating Australian pharmacists about the use of online information in community pharmacy practice

Objectives Community pharmacists practice in an information technology‐rich society, however many have not been educated in internet use for professional practice. The aims of this study were to investigate how community pharmacists use the internet in their practice; to develop an intervention to address their educational needs; and to examine the benefits and weakness of a flexible delivery programme. Method We conducted two focus groups investigating community pharmacists' internet use and education needs. We subsequently developed and provided a four‐module educational course on CD ROM, ‘Advanced web skills for pharmacists: finding quality on the internet’. In total, 147 pharmacists participated. A survey was conducted to evaluate the impact of the course. Key findings The focus group findings provided a clear rationale for an educational intervention. One‐hundred and four pharmacists completed the course. Participating pharmacists were highly positive about the learning experience, in particular the provision of education by flexible delivery. Many reported specific changes to practice. They also described the time‐consuming nature of the course as the biggest barrier to further education. Conclusions This project demonstrates the need for community pharmacists to have access to internet education. Flexible CD ROM‐based learning provided a successful delivery medium.     

Professional practices and experiences with complementary medicines: a cross‐sectional study involving community pharmacists in England

Objective As retailers of complementary medicines (CMs), pharmacists are well placed to advise consumers on the safe and effective use of these products; where CMs are available in pharmacies, pharmacists should be well informed about such products. This study explored the extent to which CMs are available in community pharmacies in England, and examined pharmacists' experiences, professional practices and training with regard to these products. Method A cross‐sectional study was conducted, involving a structured questionnaire posted to community pharmacists. Coded follow‐up mailings were sent to non‐responders after 2 and 4 months, and a reminder telephone call made after 3 months. Setting All community pharmacists in six areas (Devon, Cornwall, Bradford, Leeds, Manchester, Stockport) of England (total n = 1337). Key findings The response rate was 66.5%. Overall, 92% of respondents reported that CMs (excluding vitamins/minerals) are sold in the pharmacy in which they practise, 81% had received requests from patients/consumers for specific CMs in the previous year, and 58% had recommended CMs. Around 70% of respondents rarely/never asks about CMs use when counter‐prescribing conventional medicines or when receiving reports of suspected adverse drug reactions (ADRs) associated with conventional medicines. In total, 40% of respondents had undertaken training in complementary/alternative medicine (CAM). Pharmacists who had undertaken training were more likely to ask patients/consumers specifically about use of CMs when counter‐prescribing conventional over‐the‐counter (OTC) medicines (37.0% versus 23.4%, respectively; χ² = 17.4; P = 0.0003) and when receiving reports from patients/customers of suspected ADRs associated with conventional (prescribed or OTC) medicines (35.6% versus 23.8%, respectively; χ² = 13.0; P = 0.0003). Conclusion CMs are widely available in pharmacies in England, and pharmacists interact with users of these products. An opportunity exists for pharmacists to embrace a professional role as expert advisors on CMs. However, pharmacists' training, professional practices and competence with respect to CMs first need to improve.