title: Consumer medication information in the United States, Europe, and Australia: a comparative evaluation.
abstract: OBJECTIVE
  To evaluate the quality of patient information leaflets provided with dispensed medications in the United States, United Kingdom, and Australia.
  
  
  METHODS
  Quantitative survey by an expert panel.
  
  
  METHODS
  United States, United Kingdom, and Australia.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Patient information leaflets for atenolol, glyburide (glibenclamide), atorvastatin, and nitroglycerin (glyceryl trinitrate) from the United States, United Kingdom, and Australia.
  
  
  METHODS
  Leaflets were evaluated against U.S. consensus criteria for both clinical information and general criteria, including the design of the leaflets.
  
  
  RESULTS
  Leaflets from Australia received a mean overall score of 90% (range 83%-94%) adherence with criteria, those from the United Kingdom a score of 81% (range 73%-84%), and those from the United States a score of 68% (range 65%-77%). The U.S. leaflets achieved 50% or less adherence for contraindication and precaution information. Omissions included warnings about preexisting allergy and illness and information about drug interactions. The U.S. leaflets also scored poorly (60%) for legibility and comprehensibility. The lower U.K. score reflected shortcomings in information about how to use and monitor the medications (46% adherence) and on adverse drug reactions (64%), largely due to the lack of clear advice about urgency of action in relation to adverse drug reactions.
  
  
  CONCLUSIONS
  Leaflet quality varied more among the three countries than within each country, reflecting the regulatory context. The Australian leaflets performed well across all criteria, whereas the U.S. leaflets had significant shortcomings with the omission of vital information for the safe and effective use of the medications. A repeat survey is needed to assess whether new legislation and guidance in all three countries successfully addresses the shortcomings identified.
authors.affiliation: School of Healthcare, Faculty of Medicine and Health, University of Leeds, UK. d.k.raynor@leeds.ac.uk
authors.forename: D K Theo
authors.initials: DK
authors.lastname: Raynor
authors.forename: Bonnie
authors.initials: B
authors.lastname: Svarstad
authors.forename: Peter
authors.initials: P
authors.lastname: Knapp
authors.forename: Parisa
authors.initials: P
authors.lastname: Aslani
authors.forename: M Brooke
authors.initials: MB
authors.lastname: Rogers
authors.forename: Michelle
authors.initials: M
authors.lastname: Koo
authors.forename: Ines
authors.initials: I
authors.lastname: Krass
authors.forename: Jonathan
authors.initials: J
authors.lastname: Silcock
mesh_terms: D001315:Australia; D003256:Community Participation; D003157:Community Pharmacy Services / Q000592:standards*; D004348:Drug Labeling / Q000592:standards*; D006801:Humans; D033181:Information Dissemination; D010174:Pamphlets; D010353:Patient Education as Topic / Q000592:standards*; D011361:Professional Competence; D006113:United Kingdom; D014481:United States