A while back I blogged about the spate of mandated product information when one buys medicine. I just got a scrip from the chemist with a new format consumer information in it and I’m afraid I’m pretty pissed off with what an organised piece of stupidity it really is.
Previously I wrote this.
What depresses me is that this is not hard. All it takes is to try seriously to be useful, rather than to follow a procedure. If governments can’t do this kind of thing – or rather bugger this kind of thing up – it is depressing to think of how much more limited their usefulness is than it might otherwise be.
This one reads as a kind of send up of usefulness. Virtually everything it says is a kind of joke. Some of my favourite passages.
Do not take NAPROSYN if you have
an allergy to:
• NAPROSYN or any ingredients
listed at the end of this leaflet . . .
Ask your doctor if you have any
questions why NAPROSYN has
been prescribed for you. 1
If you take this medicine after the
expiry date has passed, it may not
work as well.
If you are not sure if you should
start taking NAPROSYN, talk to
your doctor.
Follow all directions given to you by
your doctor or pharmacist carefully.
- Now there’s an idea![↩]
Is the content government mandated? It strikes me as a tad unfair to blame the government. You are a smart man, can’t you just skim read and pick out the bits that are relevant to you – clearly not the statements of the bleeding obvious!
Yes, one size fits all is not ideal; perhaps the chemist could block out the bits you find irrelevant with a marker pen?
A leaflet that must be all things for all possible consumers will be extensive in it’s coverage and prone to incorporating redundant information.
The link that Don Arthur provided (on how to use CMI ) on your earlier piece is another example of the same situation.15 pages long and I’d bet only 1% of readers would finish the document.
As someone who has written technical inserts ( for vaccines) I will politely suggest that you have uncovered a conundrum – most consumers of medicines rarely understand all of the prescribing person’s instructions, it is unusual for most consumers to finish a course of medications and the information the Dr’s receive is clouded by the reluctance of certain patients to disclose problems which may have very significant impacts on the medication they are going to use.
It our increasingly litigious time while the CMI is required by government it also may act as a way for companies to limit their liability although a legally trained reader may need to correct this idea.
Murph,
Forgive me but I think you’re being a bit complacent. It’s quite clear what needs to be done with these documents. You need someone to actually design them. That means making some serious effort to understand how people use them, how we want them to use them and then making some difficult decisions about priorities. And then testing what one has produced and modifying to optimise. These documents are box ticking exercises. Far from useless for those who want to look up side effects and so on, but far from as good as they could be – very far. If a job is worth doing . . .
It’s doing this kind of stuff as if it actually matters.
I can appreciate that my response may suggest complacency and I think this difference in our approaches originates in our experience of the leaflets.
When writing leaflets for vaccines I went back and established how the products were constituted and then you need to run through the standard clauses – side-effects , interactions , warnings etc.
These were written for professionals not the public and this may lead to their lack of design.
No one suggested I consult either a copywriter or a designer.
An acquaintance of mine writes medical copy but he has no technical knowledge – his art director works up the layout and I’d guess then the proofs are handed over to the client for the technical services department to give it the once over.However again these ads are designed for general information transmission not to provide answers to technical enquiries.
“That means making some serious effort to understand how people use them, how we want them to use them and then making some difficult decisions about priorities. And then testing what one has produced and modifying to optimise.”
In the first point you make I’d guess that there are a multiplicity of reasons regarding ‘how’ and then the prioritisation would be problematic- the leaflet needs to be for everyone.
How people ‘want’ to use the leaflets may have the same dynamic develop when really the idea is to put the information out there and then the consumer chooses how to use it.
With the IT solutions available though the box insert really is a relic from a bygone time – at a later stage I think that once everyone is assumed to have internet access the information will be available in a more interactive way and then it can be utilised in ways to suits your concerns.
Murph,
I said you were being complacent. You also seem to be being defensive. Apparently you’ve been involved in producing these and “No one suggested I consult either a copywriter or a designer.”
I’m sorry about that, but that’s what I was suggesting.
Even if no-one else has suggested it, I think the issue here is whether what is being suggested is a good idea or not.
When you say “really the idea is to put the information out there and then the consumer chooses how to use it”, whose idea were you referring to. I was suggesting that since this is consumer information that it be made as practically useful for consumers as possible.
You may be aware that ‘product disclosure statements’ on investments are designed with a similar intent in mind – some of them run to 120 pages and they are not read and are, pretty much by definition of no use to your normal retail investor.
Still, maybe no-one told them that they should try to be useful.
Nicholas, there is a minority of people who are both sufficiently thick to need the bleeding obvious pointed out to them and sufficiently deferential to do whatever authority directs them to do. From the drug company’s POV the big problem is that if things go wrong they are sufficiently capable to hire a very non-thick non-deferential lawyer.
I think you’re being hard on whoever provides the wording.
DD, it was with such readers in mind that I was saying what I was saying.
But one confusion here I think is who is doing what. If the drug companies are producing these statements according to regulation, then clearly I’m not blaming them. I’m saying that the whole system isn’t working properly. If someone picks up and reads this script, you have most of their attention for 30 seconds. What are you doing to tell them?
In this case it’s a whole bunch of preliminaries and disclaimers.
We can do better than that.
But what exactly IS the system is designed to do?
I would have to agree with your premise that you have the reader for 30 seconds and they can then elect to inform themselves and by doing so become aware of the possible risks/interactions/unexpected side-effects or they can trust that what they already know sufficiently informs them so they can make a considered choice about whether to take a medicine or not.
Leading a horse to water and so on….
From the drug companies POV the aim is to avoid litigation and inform the public who use the product.
If the wording is too technical or extensive then my suggestion would be that for whatever is charged for a visit to a GP the consumer can have things explained to them by the caring and careful medical profession.
A useful link-http://www.australianprescriber.com/magazine/18/1/19/21
Oh come on people. Nick is right – there’s no need to say “Do not take Naprosyn if… You are vomiting blood…”
If you are vomiting blood, go to hospital. Go directly to hospital. Do not pass Go, do not collect a packet of Naprosyn. Anyone who doesn’t know this is so intellectually incapacitated as to have someone else handling their medication anyway.
So you put at the top of the document, in short snappy sentences, the things which are both relevant and important and leave – if you print them at all – the Captain Obvious legalist arse-covering until the end.
It’s a layout issue, not a content issue.
‘Anyone who doesn’t know this is so intellectually incapacitated as to have someone else handling their medication anyway.”
OK FDB but what if the vomiting is due to say too much alcohol consumption by a 20 year old and they wanted some headache relief? They may have passed blood only once at the end of a spasm of dry heaving.
“But I have a footy game in 3 hours!”
The puking may be self induced , the dehydration can make the NSAID use dangerous but you know – “I felt like crap so I took 3 anyway.”
Circumstances will always be different in every case so the PI must by it’s role be expansive.
Never misunderestimate ( love that Bushism!) the abilty of the consumer to injure themselves and yet have them completely believe they haven’t any responsibilty for the negative consquences.
PI are there to be read – the headline should be in boldface type- READ THIS FIRST AND READ IT ALL.
I should probably have prefaced my comment with the disclaimer that I think there is such a thing as acceptable risk.
Y’know, in order to protect myself against…
“OK FDB but what if the vomiting is due to say too much alcohol consumption by a 20 year old and they wanted some headache relief?”
In that case, the drug company would have an utterly trivial minute or so in court spent showing that said 20-year-old was;
a) Not of sound mind when using their product, and
b) a complete idiot.
Fdb. I’d say that but clearly you haven’t been sued by any idiot claiming that there was no warning on the peanut butter that it contained peanuts or similar.
The warnings on drugs are written or vetted by lawyers to satisfy lawyers. Any information conveyed to the user is accidental.