David J. McCaffrey

Health literacy in the pharmacy setting: defining pharmacotherapy literacy

Objective All currently available definitions of health literacy may be considered quite general. Given the complex nature of the patient-pharmacy encounter and the varying tasks required to properly and successfully consume or administer medication or to adhere to a pharmaceutical care regimen, these available definitions may describe inadequately a patient’s health literacy for the purpose of pharmacotherapy and pharmacist intervention. Therefore, the objective of this research was to conceptualize the Pharmacotherapy Literacy construct. Methods Licensed pharmacists (n=2,368) were mailed a questionnaire providing them with the Healthy People 2010 definition of health literacy and asked, “Given this definition, how would you define Pharmacotherapy Literacy?” A total of 420 usable surveys were returned of which 176 (42%) included responses to the open-ended question concerning pharmacotherapy literacy. Responses were reviewed independently and collectively by the authors. Common themes were identified, compared and discussed until consensus was reached. An initial definition was formulated and distributed to six doctoral-trained academicians and practicing pharmacists who were asked to offer their opinions of the definition as well as suggestions for its improvement. The definition was modified and subjected to further review from 15 additional doctoral-trained academicians and practicing pharmacists who provided feedback concerning its improvement. Results Based on the recommendations received from the academicians and pharmacists, the following, final definition was formulated by the authors: Pharmacotherapy Literacy - An individual’s capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g. written, oral, visual images and symbols). Conclusions As the ever-changing pharmacy environment continues to advance and become more complex in nature, a definition of health literacy specific to the pharmacy setting - thereby providing a name and a focus - may improve medication consumption, medication safety, and the patient-pharmacist relationship.

Herbal Supplement Information and the Consumer

The purpose of this study was to investigate the consumers search for information in the context of self-care decisions involving herbal supplements, and the preferences for types of information in that context. The nationwide self-administered survey included a series of mock label profiles for use in conjoint analysis, as well as attitudinal items regarding information sources and the perceived gaps in available information regarding herbal supplements. The most frequently mentioned source of information was “friends and relatives” (45%). While few respondents (10% to 20%) actually had utilized conventional health practitioners as a source of information, nearly 70% said that they might use them. The attribute considered in the conjoint analysis that was most often rated as most important was professional recommendation. A majority (73%) of respondents identified “gaps” in the information that is available to them regarding herbal supplements. Implications of the results identify potential areas for policy consideration and future research.

Effect of Direct-to-Consumer Drug Advertising Exposure on Information Search

Objective: To compare the effectiveness of disease-specific (help-seeking) direct-to-consumer drug advertising (DTCA) and product-specific (product-claim) DTCA to stimulate postexposure external information search behaviors regarding drug and disease information from physicians, pharmacists, nurses, family, and friends, as well as the use of medical references and the Internet in the United States. Methods: A two-group, posttest-only experimental design was used (380 adult asthma patients were randomly assigned to view the product-specific or disease-specific DTCA). Likelihood to seek information about the benefits, risks, costs of a new drug option, and the symptoms and severity of asthma, as well as drug and disease information in general was evaluated. Results: Exposure to disease-specific DTCA resulted in a significantly higher likelihood to seek information regarding a new drug option in general (from physicians, nurses, and family and friends) and the benefits of a new drug option (from physicians and family or friends) for the treatment of asthma than exposure to product-specific DTCA. Conclusion: Developing and implementing promotional strategies that include disease-specific DTCA could be useful as this type of advertisement appeared to be at least no less effective and in some respects more effective than product-specific DTCA in stimulating postexposure information search behaviors in experienced patients.