The Missouri evaluation protocol was used for comparing the contents of the Drugdex and de Haen drug information systems. Criteria for evaluating (1) general information content and (2) content of drug-drug interactions are given in the Missouri protocol. To check the two drug information systems for content, 113 sample drugs were randomly selected to represent all pharmacologic-therapeutic categories of the American Hospital Formulary Service. A list of 215 sample drug-drug interactions was randomly selected from Hansten's Drug Interactions. Each system was then search, applying each general content criterion and drug interaction criterion to each sample drug and sample interaction, respectively. Raw data were transformed into the Missouri protocol's seven weighted variables, and aggregate scores were obtained by summing the weighted scores for the variables. All scoring measurements were done by one investigator. Both raw (unweighted) and weighted scores were analyzed. Aggregate scores showed no significant differences between Drugdex and de Haen for either general information content or content of drug-drug interactions. However, analysis of raw data contradicted these results by showing differences between systems for several variables. The de Haen system included general information on a greater percentage of the sample drugs, but Drugdex covered more information criteria per drug. Drugdex contained a greater percentage of the sample drug-drug interactions, but de Haen covered more criteria for a listed interaction. The results of this study suggest that neither Drugdex nor the de Haen system can be recommended for use in lieu of the other. The Missouri protocol has flaws that preclude its routine use for comparative evaluation of drug information systems.
Psychological principles of writing were applied to the design of written patient medication information, and the extent to which these principles helped patients understand and recognize information about tbeir medication was evaluated. Medication information sheets for ampicillin and methyldopa were designed using two formats: (1) a read-organize-attend (ROA) format, and (2) an easy-to-read (R) format. Two hundred seventy-one patients, who were given prescriptions for either drug were randomly assigned to one of three groups: (1) a ROA group, which received the information in the ROA format, (2) a R group, which received the information in the R format, and (3) a control group, which did not receive any written information. A sorting task measured the patients' recognition of the information, and a simulation task measured the patients' ability to apply the information to situations involving the use of the drug. Following these tasks, the patients were asked about their educational level and if they had taken the drug before. There were no significant differences in either simulation scores or sorting scores between tbe ROA and R groups or between the two groups and the control group. Neither previous, experience with the medication or educational level influenced the patients' ability to recognize the medication information. Patients who received written information were less likely to attribute false information to the medication than the patients who did not receive written material: the ROA format was more effective than the R format. Written patient medication information designed using psychological principles of writing were effective in reducing patients' false alarms about their medication.
Using content analysis of written narratives, this qualitative study explored the mental representations pharmacy students used to explain their own negative health behaviors. In a behavioral pharmacy recitation class, 150 students wrote narratives in response to a question about their own negative health behaviors. Each narrative was content analyzed. The top three adverse health behaviors were poor diet, smoking and alcohol consumption. The three most common modifications included generalized knowledge acquisition or education, being committed to making a conscious effort to change negative behaviors (i.e., will power), and not responding to peer pressure. It appears that students believe they have good reasons for continuing bad behaviors. However, behavior modifications appeared to be too general to be effective. Students offered prescriptive solutions to negative health behaviors. Post assignment student evaluation showed that most students believed that further training in self-awareness (metacognition) in the pharmacy curriculum, would enhance both personal growth and professional abilities as future pharmacists.
