A survey of community pharmacy customers’ use and views of patient information leaflets for medicines in paper and electronic formats
Authors: O’Sullivan S , Dalton K 
Published: April 2024

Abstract

Introduction
Paper patient information leaflets (PILs) are currently required to accompany licensed medicines in the European Union. As paper PILs fail to meet the needs of many end-users,[1] their routine use at the current extent remains questionable – especially with sustainability in mind.[2] With the growing scope of electronic product information (ePI) for medicines, there is a clear need for greater end-user input to inform future paper PIL and ePI usage.

Aim
To explore community pharmacy customers’ (CPCs’) use and views of paper PILs, their views on ePI, and to examine whether CPCs’ characteristics influence these parameters.

Methods
A survey was conducted amongst a convenience sample of CPCs (aged ≥18 years) recruited from eleven Irish community pharmacies across 4 weeks in November and December 2022. Respondents were recruited via the primary researcher, pharmacy staff, or by following a quick response (QR) code on a poster in the pharmacy. Descriptive and inferential statistics (including chi-squared tests) were used to analyse the data, whereby p&lt;0.05 meant statistically significant differences.

Results
There were 226 valid responses (58.7% female and 41.3% male; 29.2% using ≥5 regular prescription medicines). The mean age was 49 years, with 38% aged &lt;45 years and 23% aged ≥65 years. Only 26.1% indicated that they ‘always’ read the paper PIL when they start on a new medicine, whilst 15% said it was difficult or very difficult to read the paper PIL. When asked about reading the paper PIL other than the first time, 24.8% reported that they never read the PIL again. Approximately three-quarters agreed it would be okay if paper PILs were only provided to them on the first time they received a medicine (74.8%).
Half of respondents had used the internet to check information about their medicines (50.9%). Approximately one quarter (25.7%) reported that they had accessed the official electronic PIL online previously, whilst 61.1% did not know that the official PILs for all licensed medicines are available freely on the internet for people in Ireland. Older adults (≥65 years) reported lower levels of confidence in using the internet and were less likely to use it for obtaining medicines information (p&lt;0.05). Compared to those in older age categories (45-64 years, ≥65 years), younger respondents (&lt;45 years) were significantly more likely to prefer using an electronic device to read the PIL in its electronic format instead of in its current paper format (69.3% versus 29.7%, p&lt;0.05).

Conclusion
This study has highlighted that greater consideration is needed for the extent of paper PIL usage for medicines in future. These findings indicate a high level of wastage that is exacerbating the medicines-related carbon footprint globally, and emphasise the need for more sustainable strategies to communicate medicines information. While this study’s sample size was small, it comprised views ranging from younger people on no regular medicines to older people with polypharmacy. There is a clear need to raise awareness on ePI availability and to focus greater attention on older people and those less technologically competent when designing ePI going forward.

References
1. Liu F, Abdul-Hussain S, Mahboob S et al. How useful are medication patient information leaflets to older adults? A content, readability and layout analysis. International journal of clinical pharmacy. 2014 Aug;36:827-34.
2. Skogman-Lindqvist C, Lapatto-Reiniluoto O, Sirviö M et al. Benefits and challenges of electronic package leaflet (ePL)-review of ePL pilots in hospital settings in Europe. European Journal of Pharmaceutical Sciences. 2023 Oct 10:106605.