title: Patient information leaflets: informing or frightening? A focus group study exploring patients' emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices.
abstract: BACKGROUND
  The purpose of patient information leaflets (PILs) is to inform patients about the administration, precautions and potential side effects of their prescribed medication. Despite European Commission guidelines aiming at increasing readability and comprehension of PILs little is known about the potential risk information has on patients. This article explores patients' reactions and subsequent behavior towards risk information conveyed in PILs of commonly prescribed drugs by general practitioners (GPs) for the treatment of Type 2 diabetes, hypertension or hypercholesterolemia; the most frequent cause for consultations in family practices in Germany.
  
  
  METHODS
  We conducted six focus groups comprising 35 patients which were recruited in GP practices. Transcripts were read and coded for themes; categories were created by abstracting data and further refined into a coding framework.
  
  
  RESULTS
  Three interrelated categories are presented: (i) The vast amount of side effects and drug interactions commonly described in PILs provoke various emotional reactions in patients which (ii) lead to specific patient behavior of which (iii) consulting the GP for assistance is among the most common. Findings show that current description of potential risk information caused feelings of fear and anxiety in the reader resulting in undesirable behavioral reactions.
  
  
  CONCLUSIONS
  Future PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions.
authors.affiliation: Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Moorenstr, 5, Building 14,97, 40225 Düsseldorf, Germany. Oliver.Herber@med.uni-duesseldorf.de.
authors.forename: Oliver Rudolf
authors.initials: OR
authors.lastname: Herber
authors.forename: Verena
authors.initials: V
authors.lastname: Gies
authors.forename: David
authors.initials: D
authors.lastname: Schwappach
authors.forename: Petra
authors.initials: P
authors.lastname: Thürmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Wilm
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology*; D032882:Comprehension; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004348:Drug Labeling; D005194:Family Practice; D005260:Female; D017144:Focus Groups; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy; D006973:Hypertension / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic; D036301:Qualitative Research
chemical_list: D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents