COLUMBUS, Ohio -- The information in prescription drug leaflets and consumer-oriented magazine advertisements is too complex for most people, a recent study suggests.

In experiments at Ohio State University, scientists found that people who reviewed complex drug information leaflets were significantly more confused, doubtful and overwhelmed than people who read simple or intermediate-level materials.

"These results suggest that people can get overloaded with prescription drug information," said Jon Schommer, one of the authors of the study and an assistant professor of pharmaceutical administration at Ohio State.

"When you get overloaded, you can actually make poorer decisions than if you had an adequate amount of information. If you read a drug leaflet that's burdening you with information and you begin to feel confused, you might become indecisive, misinterpret what the information is saying and take the medication in the wrong way."

These results are especially pertinent given the increasing

amount of technical drug information available to consumers, Schommer said.

"There's an information explosion," he said. "There are drug CD-ROMs. People are buying the Physician's Desk Reference like crazy. Direct-to-consumer ads for prescription drugs are showing up more and more in general interest publications. The question is whether the average consumer of prescriptions can handle the complexity of this information without detrimental consequences."

Schommer conducted the study with former graduate student Sarah L. Labor and Dev S. Pathak, Merrell Dow professor of pharmacy and marketing at Ohio State. He will present the group's findings November 8 in San Diego at the annual meeting of the American Association of Pharmaceutical Scientists.

For their study, Schommer and his colleagues designed five experimental drug leaflets about an allergy medication. The leaflets contained two to 12 topics. The simplest were written at a sixth-grade level and the most complex were written in the language of a medical professional.

The researchers distributed these leaflets randomly to 94 patients at the Ohio State University Medical Center clinic and asked these patients to read the leaflet and complete a short questionnaire. In the questionnaire, the patients indicated whether the number and complexity of topics in the leaflet was "too much," "too little" or "about right." In addition, they indicated how the information made them feel about their drug-taking decisions, how it made them feel emotionally and whether it was useful and practical.

The results:

_ Patients who read the two-topic, professional-level leaflet were the most confused, doubtful and overwhelmed about their drug-taking decisions. In contrast, patients who read the 12-topic, sixth-grade-level leaflet reported the lowest levels of confusion and doubt. "Patients want drug information that covers many topics, but they want it provided in simple language," Schommer said.

_ Although they were more confused, patients who read the more complex leaflets were not any more frustrated and angry than patients who read simpler leaflets. In addition, patients who read the more complex leaflets were no more likely to regard them as useless or unhelpful than other patients.

"This suggests that people can stop themselves short of emotional responses to varying amounts of information," Schommer said. "It also suggests people might think any kind of information is better than no information at all."

Overall, these results indicate that prescription drug information leaflets and magazine advertisements should be reevaluated, Schommer said. The number of topics covered in these materials is fine for most patients, he said. But the complexity is not.

"The technical information might be helping with liability concerns, but it might actually be hurting from a patient care standpoint," he said. "It might be having detrimental consequences in terms of drug-taking errors that result from patient confusion."

Schommer will test that idea in upcoming research. In the meantime, however, he suggests that pharmaceutical companies design information leaflets and drug ads that include both technical information and a summary of that information written at an eight-grade level. That way, both liability issues and patient understanding can be served.

"Is that burdensome for pharmaceutical companies, which already have many requirements to follow? We don't know. We're raising the question," he said.

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Contact: Jon Schommer, (614) 292-3011

Written by Kelly Kershner, (614) 292-8308