title: 3D visualization as a communicative aid in pharmaceutical advice-giving over distance.
abstract: BACKGROUND
  Medication misuse results in considerable problems for both patient and society. It is a complex problem with many contributing factors, including timely access to product information.
  
  
  OBJECTIVE
  To investigate the value of 3-dimensional (3D) visualization paired with video conferencing as a tool for pharmaceutical advice over distance in terms of accessibility and ease of use for the advice seeker.
  
  
  METHODS
  We created a Web-based communication service called AssistancePlus that allows an advisor to demonstrate the physical handling of a complex pharmaceutical product to an advice seeker with the aid of 3D visualization and audio/video conferencing. AssistancePlus was tested in 2 separate user studies performed in a usability lab, under realistic settings and emulating a real usage situation. In the first study, 10 pharmacy students were assisted by 2 advisors from the Swedish National Co-operation of Pharmacies' call centre on the use of an asthma inhaler. The student-advisor interview sessions were filmed on video to qualitatively explore their experience of giving and receiving advice with the aid of 3D visualization. In the second study, 3 advisors from the same call centre instructed 23 participants recruited from the general public on the use of 2 products: (1) an insulin injection pen, and (2) a growth hormone injection syringe. First, participants received advice on one product in an audio-recorded telephone call and for the other product in a video-recorded AssistancePlus session (product order balanced). In conjunction with the AssistancePlus session, participants answered a questionnaire regarding accessibility, perceived expressiveness, and general usefulness of 3D visualization for advice-giving over distance compared with the telephone and were given a short interview focusing on their experience of the 3D features.
  
  
  RESULTS
  In both studies, participants found the AssistancePlus service helpful in providing clear and exact instructions. In the second study, directly comparing AssistancePlus and the telephone, AssistancePlus was judged positively for ease of communication (P = .001), personal contact (P = .001), explanatory power (P < .001), and efficiency (P < .001). Participants in both studies said that they would welcome this type of service as an alternative to the telephone and to face-to-face interaction when a physical meeting is not possible or not convenient. However, although AssistancePlus was considered as easy to use as the telephone, they would choose AssistancePlus over the telephone only when the complexity of the question demanded the higher level of expressiveness it offers. For simpler questions, a simpler service was preferred.
  
  
  CONCLUSIONS
  3D visualization paired with video conferencing can be useful for advice-giving over distance, specifically for issues that require a higher level of communicative expressiveness than the telephone can offer. 3D-supported advice-giving can increase the range of issues that can be handled over distance and thus improve access to product information.
authors.affiliation: eHealth Institute, Linnaeus University, Kalmar, Sweden. martin.ostlund@lnu.se
authors.forename: Martin
authors.initials: M
authors.lastname: Ostlund
authors.forename: Nils
authors.initials: N
authors.lastname: Dahlbäck
authors.forename: Göran Ingemar
authors.initials: GI
authors.lastname: Petersson
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006302:Health Services Research; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010593:Pharmaceutical Services / Q000706:statistics & numerical data*; D015397:Program Evaluation; D019114:Remote Consultation / Q000379:methods*; D013548:Sweden; D017216:Telemedicine / Q000379:methods*; D055815:Young Adult