Hammar T, Nilsson AL, Hovstadius B. Patients’ views on electronic patient information leaflets. Pharmacy Practice
2016 Jan-Mar;14(2):702.
doi: 10.18549/PharmPract.2016.02.702
Original Research
Patients’ views on
electronic patient information leaflets
Tora HAMMAR
, Anna-Lena NILSSON
Received (first version):
19-Nov-2015
*
ABSTRACT
Background: Information in society and in health care is
currently undergoing a transition from paper to digital
formats, and the main source of information will probably
be electronic in the future.
Objective: To explore patients’ use and perceptions of the
patient information leaflet included in the medication
package, and their attitude towards a transition to an
electronic version.
Methods: The data was collected during October to
November 2014 among individuals in South-Eastern
Sweden, using a questionnaire (n=406, response rate
78%) and interviews (n=15).
Results: The questionnaire showed that the majority of
the respondents (52%) occasionally read the patient
information leaflet, 37% always read it, and 11% never
read it. Almost half of the patients (41%) were positive
towards reading the patient information leaflet
electronically while 32% were hesitant and 26% neutral. A
majority of the patients would request to get the patient
information leaflet printed at the pharmacy if it was not
included in the package. There were differences in attitude
related to age and gender. The interviews showed that
patients had mixed views on a transition to an electronic
patient information leaflet. The patients perceived several
positive aspects with an electronic patient information
leaflet but were concerned about elderly patients.
Conclusion: Although many were positive towards
reading the patient information leaflet electronically, the
majority prefer the patient information leaflet in paper form.
Providing appropriate and useful eHealth services for
patients to access the patient information leaflet
electronically, along with education, could prepare patients
for a transition to electronic patient information leaflet.
Keywords: Drug Labeling; Telemedicine; Patient
Medication Knowledge; Patient Education as Topic;
Pharmacies; Surveys and Questionnaires; Qualitative
Research; Sweden
*
Tora HAMMAR. PhD. Researcher. eHealth Institute,
Department of Medicine and Optometry, Linnaeus
University. Kalmar (Sweden). tora.hammar@lnu.se
Anna-Lena NILSSON. MSc. Researcher. eHealth
Institute, Department of Medicine and Optometry,
Linnaeus University. Kalmar (Sweden). annalena.nilsson@lnu.se
Bo HOVSTADIUS. Associate professor, research fellow.
eHealth Institute, Department of Medicine and Optometry,
Linnaeus University. Kalmar (Sweden).
bo.hovstadius@lnu.se
www.pharmacypractice.org
, Bo HOVSTADIUS
Accepted: 18-Apr-2016
.
INTRODUCTION
For safe, effective drug treatment, it is important
that patients are well informed, understand which
medicines they are supposed to take and how to
use them, and understand the expected benefits
and possible side effects of the drugs.1-4 Patient
adherence to drug treatment is vital to reach the
desired outcome. However, non-adherence to
treatment is common for various reasons, such as
adverse drug events and lack of motivation,
knowledge or information.1,5,6 Patients often
misunderstand or forget much of the information
given by their physician or other healthcare
professionals
during
consultation.7,8
Written
information is known to increase the amount of
information retained.9,10
In the EU, pharmaceutical companies are legally
required to include a patient information leaflet in all
medication packages.2,11 The patient information
leaflet is also often referred to as the package
information leaflet, the patient medication leaflet,
consumer medicines information, the package
leaflet, or the package insert. The content of the
patient information leaflet should be in accordance
with the Summary of Product Characteristics
(SmPC). The purpose of the patient information
leaflet is to communicate important information from
the manufacturer to the patient in order to ensure
that the medication is taken correctly and used as
intended.12
Providing a patient information leaflet can improve
patients’ knowledge about the medication, but
reading the patient information leaflet can also
result in non-adherence.2,11,13 Several studies have
shown that the current patient information leaflets
do not meet the needs of all patients.2,14-16
Problems that have been described include the text
being too long and the font size too small, the
presence of incomprehensible medical terms, the
misinterpretation of benefits and risks, the
complicated folding to fit it in the medication
package, exclusion of ethnic minorities because of
second language issues, and variations in the
information between different brands of generically
identical drugs. In Sweden, the patient information
leaflets for all registered drugs are available online
via www.fass.se, provided by LIF, a professional
association
representing
research-based
pharmaceutical companies in Sweden. The website
www.fass.se is being increasingly used, with
approximately four million visits each month; more
than half of the visitors are patients and the rest are
healthcare professionals.17 However, it is not known
how Swedish patients feel about accessing or
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Hammar T, Nilsson AL, Hovstadius B. Patients’ views on electronic patient information leaflets. Pharmacy Practice
2016 Jan-Mar;14(2):702.
doi: 10.18549/PharmPract.2016.02.702
reading their medication information electronically
compared with receiving the paper leaflet.
Today, patients are becoming increasingly engaged
in their own health care, a development that is
supported by the growth of information technology
in our society.18,19 The internet is becoming an
increasingly important source of health information;
the majority of adults seek health information online,
although the quality of this information is
variable.10,19-22 Informed, motivated patients are
more likely to continue using healthcare services, to
value and maintain relationships with healthcare
providers, to comply with treatment, and to take an
active role in their own health care.23-25 During
recent decades, the prescribing of medications and
handling of information in the medication
management process have gone through a major
transition from paper-based to electronic.4,26
Medical information and services, communication,
and education for patients are also becoming
increasingly digitalised and mobile.27,28 For
example, patients in Sweden can access
information regarding current prescriptions online29
and, in some regions, patients can access their
electronic health records online.30 Different
countries vary in the degree to which eHealth
services are implemented and in the use of the
internet by their citizens.27,31 In Australia, the patient
information leaflet (Consumer Medicine Information)
is not required to be included in the medication
package, and can be provided electronically
instead, but the dissemination of the information is
not as high as desirable.32
To meet the future needs of patients, it is desirable
to improve the content of the patient information
leaflet, but it is also important to investigate different
forms for communicating the information to the
patient, for example by providing the patient
information leaflet online or integrated in other
eHealth services.33 One positive impact with an
electronic patient information leaflet is that the
information can be instantly updated instead of it
taking years for updates to reach the patient. Using
an electronic patient information leaflet also offers
opportunities for increased availability with mobile
devices, and increased usability by allowing the
patient to change the font size or use an audio
version of the text, or to get difficult medical terms
explained.34,35 Other possible effects are that more
countries could share the same medication
package, and that unnecessary disposal of
medication could be minimised. Previous research
internationally have explored different aspects of
written medication information provided to patients,
such as how to improve the content and format of
the information as well as increasing the
dissemination among patients.32,33,36,37 However,
research with focus on patient attitudes towards
receiving the information electronically compared
with paper form is limited.
The aim of this study was to explore patients’ use
and perceptions of the current patient information
leaflets included in medication packages, as well as
their attitudes to a potential transition to an
electronic version.
www.pharmacypractice.org
METHODS
A mixed methods approach was used by collecting
the data via a questionnaire and interviews. Both
included similar questions regarding current usage
of the patient information leaflet, and views on
reading the patient information leaflet electronically
in the future. However, while the questionnaire
included only a few multiple choice questions, the
interviews aimed to provide a greater understanding
regarding views and preferences.
Questionnaire
The questionnaire was developed for this study
based on previous research and experience with
questionnaires. The questionnaire was reviewed by
four researchers from different disciplines and
tested among a few individuals before the large
scale study. The questionnaire in Swedish
comprised six questions along with those relating to
the respondents’ age and gender, and also included
a short description of what a patient information
leaflet is (Online appendix).
Data was collected at seven pharmacies in SouthEastern Sweden from October 10th to November
14th 2014. The pharmacies of different sizes and in
different types of location (i.e. small city, medium
sized city, and hospital) were selected to capture a
wide range of patients. One or two of the
researchers visited each pharmacy for two to five
hours at different times during the day to collect
data using the questionnaires. All individuals visiting
one of the participating pharmacies during one such
occasion in order to collect prescription medication
were included in the study, and asked to participate
by filling out the questionnaire after being informed
of the research. Before the study it was calculated
that at least 384 answers were needed to answer
the main question (How would you feel about
reading the patient information leaflet electronically
on a computer, phone or tablet?), for a population of
more than 100 000, with a margin of error of 5%
and a confidence level of 95%. It was decided that
data was going to be collected until at least 400
answers to the questionnaire had been collected.
Interviews
The interviews followed a pre-defined interview
guide comprising 19 questions (Online appendix).
The semi-structured interviews were conducted
face-to-face or via telephone during November
2014. Each interview lasted between 10 and 25
minutes, was recorded with the respondent's
permission and was transcribed.
The participants for the interviews were strategically
selected from different settings in South-Eastern
Sweden in order to include individuals of different
ages, genders, and experience with medication.
Participants were included until saturation in the
answers were found and sufficient data were
considered to be achieved. At the end of the
interview, the respondents were presented
a
number of assumed benefits of an electronic patient
information leaflet compared with the paper-based
form: (1) instant updates can be made instead of
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Hammar T, Nilsson AL, Hovstadius B. Patients’ views on electronic patient information leaflets. Pharmacy Practice
2016 Jan-Mar;14(2):702.
doi: 10.18549/PharmPract.2016.02.702
Table 1. Respondents’ characteristics (n=406).
Respondents
Respondents (%)
Gender
Female
253 (62%)
Male
153 (38%)
Age (years)
≤ 25
28 (7%)
26-55
172 (42%)
56-85
203 (50%)
≥ 86
3 (<1%)
Use of medications
Continuously
233 (57%)
Periodically
61 (15%)
Occasionally
112 (28%)
waiting years for the updates to reach the patient,
(2) there could be increased usability, allowing the
patient to change the font size, use an audio version
of the text, or have difficult medical terms explained,
and (3) there could be environmental benefits
because of decreased disposal of medication as a
result of information updates. After receiving
information of assumed benefits, the respondents
were again asked for their views about accessing
and reading the patient information leaflet online.
Analysis of data
The responses to the questionnaires were analysed
using SPSS software (IBM SPSS statistics 22). The
chi-squared test was used to analyse the
relationship between the respondents’ answers and
their age and gender, with p<0.05 as the level for a
significant relationship. When analysing possible
differences in attitude between age groups in this
study, the respondents were divided in two (aged 55
or younger and over 55 years). The manifest
content of the transcribed interviews was analysed
using qualitative description method.38,39 The data
were analysed and categorised using QSR NVivo
10 software. Representative quotes were selected
for the main aspect of the interviews to exemplify
the different perspectives. Quotes were then
translated from Swedish to English. One researcher
analysed all the interviews and the results were
validated by two other researchers.
Ethical considerations
The ethical implications of the study were
considered based on the guidelines of the Ethics
Committee of South-East Sweden. Personal
identifiers were removed or disguised, and data was
handled in a way so that the respondents cannot be
identified.
RESULTS
Questionnaire
In total, 523 pharmacy customers were included
and asked to complete the questionnaire; 95
individuals declined and 406 accepted and thus
responded to the questionnaire (response rate
78%). A summary of participant characteristics is
given in Table 1. Approximately half of the
respondents (49%, n=200) were aged 55 years or
younger.
The majority of the respondents (52%, n=213)
occasionally read the patient information leaflet,
37% (n=150) always read it, and 11% (n=43) never
read it. There was a significant difference between
genders in how often they read the patient
information leaflet (p<0.05), with females reading it
more often than males, but there were no significant
differences among age groups (Figure 1).
The majority of respondents (55%, n=225) preferred
to read the patient information leaflet in its current
form included in the medication package, 17%
(n=69) would prefer it in electronic form, 13% (n=52)
preferred it printed at the pharmacy, 11% had no
opinion and 4% gave more than one answer (Figure
2).
When asked how they would feel about reading the
patient information leaflet electronically on a
computer, phone or tablet, almost half of the
participants were positive (41%, n=168) while 32%
(n=131) were hesitant/uncertain and 26% (n=107)
were neutral. For this question, there was a
significant difference (p<0.05) in attitudes between
respondents aged 55 years or younger and those
aged 56 years or older; the younger respondents
were more positive (Figure 3), but there was no
significant difference between the genders.
If the patient information leaflet was not included in
the package, more than half (54%, n=220) stated
that they would ask to get the patient information
leaflet printed at the pharmacy, 26% (n=104) stated
Figure 1. Answers to the question “How often do you read the information on the patient
information leaflet?”, according to gender (left) and age group (right).
www.pharmacypractice.org
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Hammar T, Nilsson AL, Hovstadius B. Patients’ views on electronic patient information leaflets. Pharmacy Practice
2016 Jan-Mar;14(2):702.
doi: 10.18549/PharmPract.2016.02.702
Figure 2. Answers to the multiple-choice question “How would you prefer to receive the
information currently provided in the patient information leaflet?” with four alternatives.
Some of the respondents chose several alternatives.
that they would not, and 20% (n=81) said that they
did not know. There was a significant (p<0.05)
difference between the two age groups, with those
aged 56 years or older more often stating that they
would ask to get the patient information leaflet
printed (Figure 4), but there was no significant
difference between the genders.
Interviews
Fifteen respondents participated in the interviews
(eight female and seven male); they were aged
between 24 and 89 years with a mean age of 49
years.
The
respondents’
experience
with
medications varied; some used medications daily
and some only occasionally. A few respondents
also helped another family member with their
medication.
Information regarding medications:
The respondents obtained information regarding
medications from the prescriber, pharmacists at the
pharmacy, a family member with more knowledge
regarding medications, the patient information
leaflet included in the package, online information
sources, or advertisements.
”I get the information from the patient
information leaflet and, of course, first of all
from the physician.” (female, 67 years)
”Primarily online via fass.se, and secondarily I
turn to my doctor” (female, 52 years)
Many of the respondents used the internet to find
information regarding medications, but a few had
never felt the need or been able to use the internet
for this reason. The most commonly mentioned
source of information online was www.fass.se but
several said that they used Google to find the
information they wanted.
”I have read fass.se sometimes, if there was
something I wanted to investigate more
deeply.” (female, 45 years)
”I'd probably just ‘google’ it and see what
came up, see what was believable. Often
there are forums where people have written
about similar side effects or whatever I want
to know about regarding the drug, and then
you can probably find your way there.”
(female, 24 years)
Usage of and perceptions about the patient
information leaflet included in medication packages:
Almost all the respondents answered that they read
the patient information leaflet included in the
medication package, at least occasionally. Some
said that they almost always read the patient
Figure 3. Answers to the question “How would you feel about reading the patient information leaflet
electronically on a computer, phone or tablet?” according to gender (left) and age group (right).
www.pharmacypractice.org
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Hammar T, Nilsson AL, Hovstadius B. Patients’ views on electronic patient information leaflets. Pharmacy Practice
2016 Jan-Mar;14(2):702.
doi: 10.18549/PharmPract.2016.02.702
Figure 4. Answers to the question “If the patient information leaflet was not included in the medication
package, would you ask to get it printed at the pharmacy?” according to gender (left) and age group (right).
information leaflet to find out more about their
treatment and gain a better understanding of it. The
reasons for reading the patient information leaflet
among those who only read it sometimes included:
the medication was new to them, the type of
medication, questions regarding use during
pregnancy, suspicion of adverse effects, reports in
the mass media regarding the medication, or
questions regarding mixing the medication with
alcohol.
”A new medication means that I will read the
patient information leaflet.” (female, 45 years)
”It can depend on the type of medication. If it
is something I expect or believe has side
effects, I am more anxious to check them than
the medication I believe or expect is more
harmless. In that case I may not care as much
about looking at the patient information leaflet
at all.” (male, 32 years)
When asked which information they read in the
patient information leaflet, almost all the
respondents mentioned information regarding
adverse effects. Other issues mentioned were
information regarding dosage and user instructions.
The respondents generally thought the current
patient information leaflet was good, but most of
them also perceived problems including: the text is
too small, it can be difficult to find the information
they are searching for, or the language is difficult to
understand. Other negative aspects included that
the current patient information leaflet in paper form
is difficult to get back into the package once they
had read it, and that it was easily lost because of
that. Most of the respondents did not lack any
information in the patient information leaflet, but one
respondent was missing information regarding
interactions with other medications.
Preferred format for medication information:
More than half of the respondents regarded the
electronic format as more practical, but some
preferred to read the patient information leaflet in
paper form (included in the package), or to get the
patient information leaflet printed at the pharmacy.
Even among those who preferred reading the
information electronically, some still wanted the
patient information leaflet to be included in the
medication package. Some preferred the electronic
form for themselves but did not think it would work
for all patient groups, for example the elderly.
”I would like to have it in my mobile phone, I
think.” (male, 24 years)
”I think that it is probably good to have it as it
is today in paper form but also to have it on
Fass.se online. I believe there are different
target groups, elderly people, for example,
who may not have access to the Internet.”
(female, 24 years)
Perceptions of a possible transition to electronic
patient information leaflets:
Most of the respondents felt positive about reading
the patient information leaflet electronically, for
example on a computer, smart phone or tablet, but
a few were more hesitant or negative. Possible
problems with electronic patient information leaflets
described by the respondents included worries
about the elderly not being able to access the
medication electronically, problems related to
privacy, or trouble finding the right information for
their specific medication.
”It would be wonderful! And I'd be more
curious!” (male, 48 years)
”A lot of text, often written in small letters, and
it can be difficult to find just what you're
looking for.” (female, 24 years)
”If I look to myself, it would be more
convenient to get it online. But for my parents,
it would be a disaster. They have no computer
and need the paper form.” (female, 52 years)
”It’s difficult to get it back into the package
once you’ve unfolded it. It gets wrinkled and
messy or you throw it away and then it’s not
there the next time you need it.” (female, 34
years)
Some respondents said that if the information was
going to be relayed electronically, they wanted
some form of guidance to find the right information,
for example by getting an email, a link, or an SMS
(text message), or via a chip (e.g. NFC, near field
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Hammar T, Nilsson AL, Hovstadius B. Patients’ views on electronic patient information leaflets. Pharmacy Practice
2016 Jan-Mar;14(2):702.
doi: 10.18549/PharmPract.2016.02.702
communication) or code (e.g. QR, quick response)
on the medication package.
”The dream would be to get it in an email
when I’ve received a prescription.” (female, 45
years)
”Maybe it's not super easy to go to fass.se
and find it there. One could imagine a QR
code on the package that you can scan, or
maybe an NFC chip on the package. There
should be some kind of link between the
medicine I receive in my hand, and the
information I get. It is easy to confuse two
similar names, which might have serious
consequences if you receive the wrong
information.” (male, 32 years)
The respondents described several benefits
associated with an electronic patient information
leaflet: being able to increase the font size, being
able to access other visual instructions, or it being
easier to find the information they seek without
having to read the whole patient information leaflet.
”I can come up with several uses and
benefits. If some medicines need more
instructions, there is the possibility of adding
pictures or instructional videos.” (male, 32
years)
”From an environmental point of view I think
computers are better, and it might be easier to
find exactly the information you want without
having to read a lot of unnecessary text, and it
might be faster.” (female, 34 years)
After receiving the information regarding the
possible benefits of an electronic patient information
leaflet, most respondents had a more positive view
on the possible transition to an electronic patient
information leaflet. However, their previously
described problems or worries remained the same.
DISCUSSION
The study showed that although most patients read
the patient information leaflets included in
medication packages at least sometimes, they
perceived several weaknesses associated with this
format. Many patients use electronic medication
information to some extent. The patients had mixed
views on a future transition to electronic patient
information leaflets. Although many were positive
towards reading the patient information leaflet
electronically, the majority still prefer paper patient
information leaflet included in the medication
package. Patients saw several positive aspects
associated with an electronic patient information
leaflet, but were concerned about elderly patients
who they believe depend on paper-based
information. The majority of patients stated that they
would ask to get the patient information leaflet
printed at the pharmacy if it was not included in the
package. The results indicated differences in
attitude related to age and gender.
www.pharmacypractice.org
Differences in the results between the
questionnaire and the interviews
There were some differences in attitude to
electronic patient information leaflets between the
findings of the questionnaire and those of the
interviews, with the interviews indicating a more
positive attitude. There are several possible
explanations for this. The interviews allowed the
respondents to explain their concerns regarding
electronic patient information leaflets, revealing that
many respondents were positive towards reading
them electronically themselves but were worried
about the elderly being unable to read them
electronically. Perhaps the more negative attitude
seen in the questionnaires reflected worries about
others rather than themselves. The interviews also
indicated that a negative attitude might not reflect
on the electronic format itself, but rather on
insecurities about how to find the right patient
information leaflet, which could be managed if there
was a way to guide the patient to the correct patient
information leaflet for their medication, for example
via an SMS, email, chip or digital barcode, or even
including the patient information leaflet with other
eHealth patient services such as their online list of
current medications. The interviews also showed
that providing information on the possible benefits of
electronic patient information leaflets could lead to a
more positive attitude. Because electronic patient
information leaflets have probably not been
considered by most patients before, this short
questionnaire without any background information
could have increased the likelihood of patients
being in favour of the current form rather than
opening up to something new.
Respondents’ perceptions of current
information sources
The sources the respondents used to obtain
information regarding their medications were similar
to those mentioned in other studies.40-43 Online
sources are becoming increasingly important for
health information19-21, but some of the respondents
in this study were unsure of how to find correct,
reliable information about their medications. The
questionnaire showed that the majority of
respondents wanted the patient information leaflet
printed at the pharmacy if it was not included in the
package. However, if a similar question had been
included asking if the respondents would want, for
example, an email with their patient information
leaflet sent to them, perhaps a large proportion
would prefer that. The findings regarding usage and
perceptions of the patient information leaflet were in
line with those of other studies, and the problems
associated with the patient information leaflet were
also similar to those described in other
studies.2,13,34,44 There are a large number of studies
internationally on how to improve the content and
format of written information about individual
medications to meet the need of patients.33,45,46
The results showed that patients aged 56 years or
older had a more negative attitude towards reading
the patient information leaflet electronically. The
study also indicated that females read the patient
information leaflets more often than males, and that
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Hammar T, Nilsson AL, Hovstadius B. Patients’ views on electronic patient information leaflets. Pharmacy Practice
2016 Jan-Mar;14(2):702.
doi: 10.18549/PharmPract.2016.02.702
males might be more positive towards an electronic
patient information leaflet than females. Problems
related to the elderly being excluded or affected
negatively when information or services are
digitalised are often discussed when introducing
eHealth services.47 However, some of the
weaknesses associated with the current patient
information leaflet format, like small font size, too
much information, and difficult language, represent
major issues for the elderly.2,14 Thus, the potential
for increased usability with electronic information
may be beneficial for the elderly as well. In addition,
problems with the elderly being excluded from the
digital society are an issue that will decrease with
the passage of time.
Transition towards electronic information
formats
Information in society and in health care is currently
undergoing a transition from paper to digital
formats, and the main source of information will
probably be electronic in the future. Digital
information provides several benefits, such as
increased availability, mobility, usability and
individualisation, instant updates, and benefits for
the environment as a result of the decreased use of
paper and wastage of drugs. At the same time,
current information available online from different
sources varies in quality and reliability, and requires
the patient to know how to find the information.
It seems very likely that patient information leaflets
will primarily be provided in an electronic format in
the
future.
For
example,
in
Australia,
pharmaceutical companies are no longer obliged to
provide consumer medicine information in the
medication package, as long as it is provided online
or is printed at the pharmacy.32 However, the
dissemination and use of the written medicines
information in Australia is lower than desired and
there are several studies on how to improve
this.32,45 Our results show that the majority of
patients prefer the patient information leaflet
included in the medication package, but many are
interested in and ready to use electronic sources.
As with other new interventions, it may take time to
prepare users for the transition. Before, during, and
after such a transition, it is important to help and
educate patients to find the correct information and
to provide alternatives such as a patient information
leaflet printed at the pharmacy. Providing good
services for patients to be able to access the patient
information leaflet electronically, perhaps integrated
with other eHealth services such as the patients’ list
of current medications, could make patients less
dependent on the paper patient information leaflet
included in the medication package and prepare
them for a future transition to an electronic patient
information leaflet.
Methodological strengths and limitations
The mixed methods approach used in this study is
one of its strengths, with the questionnaire providing
quantitative results, and the interviews providing
deeper insight to prevailing attitudes. However, a
larger population might have revealed significant
differences between age groups and genders for
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more questions and made it possible to detect
differences related to experience with medications
or the type of pharmacies the patients are visiting.
The participants for both the questionnaire and the
interviews were recruited from a population in
South-Eastern Sweden in small and medium-sized
cities, thus limiting generalisation of the results to
large cities and other countries. The inclusion of
respondents who visit a pharmacy is known to result
in a slightly unrepresentative population, since
some patient groups (such as the elderly) may not
visit the pharmacy themselves but instead send a
relative or caretaker.48 Some respondents helped
older relatives with their medication and their
answers seemed to reflect concerns from the
perspective of the elderly as well. However, future
research should be designed to collect information
directly from older patients.
Future studies
Future research should study patient needs related
to the content, form, and design of the patient
information leaflet.
Different approaches for
providing
the
patient
information
leaflet
electronically to patients should be evaluated, such
as directing patients to the correct online
information using an SMS, an email, a chip or a QR
code on the medication package. Other approaches
that could be explored include integrating the
patient information leaflet into other patient services
related to their medication. Studies similar to this
one should be performed when new services have
been provided and patients are more used to
reading the patient information leaflet electronically.
Practical implications
It seems likely that the main format for the patient
information leaflet will be electronic in the future. In
order to prepare patients for a future transition to
electronic patient information leaflets it is desirable
that health care provide appropriate services so that
patients can access the patient information leaflet
electronically, perhaps integrated with other eHealth
services, along with increasing the available
information and education resources regarding
electronic services.
CONCLUSIONS
The study showed that most patients read the
patient information leaflets included in medication
packages at least sometimes but perceived several
weaknesses associated with this paper form. The
patients had mixed views on transitioning to an
electronic patient information leaflet. They saw
several positive aspects associated with a future
electronic patient information leaflet, but were
concerned about elderly patients depending on
paper-based information. Although many patients
were positive about reading the patient information
leaflet electronically, the majority still prefer the
patient information leaflet in paper form as currently
included in the medication package. A future
transition to electronic patient information leaflet
should therefore be supported by extensive
information and education to patients regarding
electronic
services.
(eISSN: 1886-3655 ISSN: 1885-642X)
7
Hammar T, Nilsson AL, Hovstadius B. Patients’ views on electronic patient information leaflets. Pharmacy Practice
2016 Jan-Mar;14(2):702.
doi: 10.18549/PharmPract.2016.02.702
ACKNOWLEDGEMENTS
CONFLICT OF INTEREST
The authors would like to thank Ulrika Lönnbom for
assistance during the design of questionnaires and
interviews, and participating in the collecting of data.
The authors would also like to thank Professor
Göran Petersson for valuable feedback on the
manuscript.
The authors declare no conflict of interest.
Funding: The study was funded by grants from the
trade
association
for
the
research-based
pharmaceutical
industry
in
Sweden,
“Läkemedelsindustriföreningen” (LIF). The study
was designed and conducted independent of the
funding organisation.
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