How good are pharmacists at judging drug-related risks?

[Ian Dawson]

Hi

I am looking for the help of UK-based pharmacists with the following …

I am a researcher at the University of Southampton and I am working on a project that concerns people’s ability to judge health risks. I am particularly interested in how well people judge the risks relating to pharmaceutical drugs, and how factors such as experience, age, knowledge, etc. may enhance this ability.

I am, therefore, reaching out to the pharmacy community to find out more about their experiences, and to get an idea of whether pharmacists judge drug-related risks more accurately than other members of society. The answer to this question may seem obvious, but it is of particular interest given that most people now have easy access to a certain amount of drug-risk information via the internet, medical packaging inserts, healthcare professionals, NHS Direct, etc.

In short, I would like to ask for the help of the members of the ‘Pharmacy Forum UK’ with two things:

1. I am running an online survey that involves making judgments about risks in relation to drugs and other health hazards. Please could you consider completing this survey, so that I can get an idea of how UK-based pharmacists judge drug-related risks? It only takes 5-10 minutes, and you are not asked to provide any details concerning your identity or personal experiences. However, if you wish, after you have completed the survey, you can contact me via email (address is on the survey), and I will endeavour to provide you with a summary of your results. Here is a direct link to the survey:

www.isurvey.soton.ac.uk/condition_start.php?id=49



2. Please can you let me know, via the forum, what your views are on the following:

- Are there any common misconceptions you frequently encounter, amongst customers/patients, concerning the risks of commonly prescribed/sold medications?
- Do many customers/patients demonstrate a good understanding of the risks presented by poly-pharmacy and drug-interactions?
- In what ways could the risks that some drugs present be better explained/communicated to the public?

I will be very grateful for any help you can offer. An end-goal for this project is to identify ways to better educate people about drug-related risks. So, hopefully, any information you can provide will go towards a process that is of benefit to all drug users and practicing pharmacists.

Many thanks for your time,

Ian.

[johnep]

Big can of worms. Heated discussion on the forum at the moment re restrictions on paracetamol. Pts think no risks. However. over dosage could lead to liver failure and death.
johnep

[Ian Dawson]

Many thanks for the reply johnep. I have read about some of the risks associated with paracetamol - particularly when taken with some anticoagulants such as warfarin.

You mentioned some heated discussions - do you know which post I can follow this discussion on please?

Ian.

PS Do you know if the URL in my original message is active? It now seems to be de-activated.

[johnep]

I always go to newest posts and none at present. Search for recent posts on paracetamol
Sorry, was on locumvoice. Mystery shopper Paracetamol.
johnep

[DavidS]

Common misconceptions:
herbal products are a. safer, and b. less effective than pharma synthesised medicines
advertised products are better than non-advertised, cheaper, generic products
what the doctor says is always correct

I found the survey very interesting to complete.

[Defblade]

I was involved in a group excerise once that I think is very relevent to this.

We were asked to rate, as a percentage, the frequency implied by various words - working from the example "When I turn the key, my car blank starts". Words to fill the gap would have included things like usually, sometimes, mostly, often, rarely. So you might say "usually" is 95% of the time, "sometimes" could be 10%. As you'd expect, there was a range of answers for each word.

The thing that really stuck with me, though, was that there were 2 absolutes included in the list - "always" and "never". One person present rated those at 90% and 10% respectively.

So you really can't assume that what something implies to you will imply the same to anyone else.

Of course, "common", "rare", "very rare" have specific meanings (1 in whatever number of patients taking the med) when properly used within side effect frequency.... but I don't know them off the top of my head!

[Ian Dawson]

Hi DavidS,

Thank you for telling me about your experiences of patient's drug-misconceptions. Its interesting to learn that the benefits of herbal medication appear to be very under-rated, and quite surprising to hear that doctors aren't always right when it comes to drug-knowledge (does this lead to many problems for pharmacists?)

Also, thank you very much for filling out the survey (please email me if you need more feedback) - its a great help . If you know any other pharmacists who would be interested in filling it out, please pass on the link. As I'm sure your aware, the more responses I get, the more accurate a picture I can form of how well informed UK pharmacists are when it comes to drug-risks.

Best wishes,

Ian.

[Ian Dawson]

Hi Defblade

Thanks for your help. I certainly agree that you can't assume that certain words will be interpreted as you intended - particularly words that describe risk and probability. This topic has been the subject of much research for quite a while now, with numerous studies exploring how quantitative (e.g. 15%, 1 in 100, etc.) or qualitative (e.g. "rarely", "often", etc.) descriptions of probability affect people's understanding of risk. Like you say, the qualitative terms are open to (mis)interpretation. But the quantitative ones are also often misunderstood or make little sense to people who are less familiar with this numerical terminology. This is a tricky dilemma for anybody involved in explaining health risks!

If you know any other pharmacists who would be interested in filling out the survey, please feel free to pass the link on - the more responses, the more accurate a picture I can form of how well UK pharmacists judge drug-risks.

Once again -many thanks,

Ian.

[Defblade]

Like you say, the qualitative terms are open to (mis)interpretation. But the quantitative ones are also often misunderstood or make little sense to people who are less familiar with this numerical terminology. This is a tricky dilemma for anybody involved in explaining health risks!

I've always felt (and often said/typed) that a big part of my role is explaining stuff to people in a way they understand. Means taking a quick view of who you're dealing with to start with and being sensitive to their feedback (verbal or non-) as to whether you're doing OK or should be getting more or less complicated. It's a skill I enjoy using and find very satisfying professionally when someone comes in confused and goes out not (although often without a concrete answer, given risk:benefit etc.... but at least hopefully they understand things aren't black and white!).

[Ian Dawson]

I've always felt (and often said/typed) that a big part of my role is explaining stuff to people in a way they understand. Means taking a quick view of who you're dealing with to start with and being sensitive to their feedback (verbal or non-) as to whether you're doing OK or should be getting more or less complicated. It's a skill I enjoy using and find very satisfying professionally when someone comes in confused and goes out not (although often without a concrete answer, given risk:benefit etc.... but at least hopefully they understand things aren't black and white!).

It seems that it is the personal interaction between you and your customers that can make a big difference as to whether they understand the risk/benefits of certain drugs. What sort of information do you find tends to help the customers the most, and how do you ensure your knowledge of risks/benefits is kept up-to-date and accurate (particularly when there are so many different drugs and a multitude of drug-drug combinations?).