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November 09, 2005

Editorial on Open Access in a Leading Medical Journal

Joanne M Shaw, Geraldine Mynors, and Caroline Kelham, Information for patients on medicines, BMJ, November 5, 2005. An editorial. Excerpt by P.Suber:

Information for patients on medicines should be much more accessible and patient centred....The traditional model for communicating with patients about their medicines is that doctors decide the best treatment and patients follow their doctors' instructions with only limited independent access to information about treatment. The Association of the British Pharmaceutical Industry (ABPI) is now reviewing its code of practice, and this is an important opportunity to move to a more modern view of patients --as partners of health professionals and decision makers in relation to their health. The main aim of the code is to protect patients from potentially harmful influence. It currently focuses heavily on regulating the pharmaceutical industry's communications with health professionals and imposes highly restrictive conditions on direct communication with patients. This model is seriously flawed. The ABPI code of practice should reflect the increasing role that patients are taking in decisions about their health and treatment, as well as patients' entitlement to access information from any source they choose. The code should require companies to provide better information for members of the public who seek it, rather than prevent them from doing so....Around half of all medicines are not taken as prescribed, with serious consequences in terms of preventable ill health, mortality, and cost to the NHS. Non-compliance is almost always the result of conscious choices made by patients rather than forgetfulness. The best predictors of compliance are patients' attitudes, beliefs, and perceptions about their illness and treatment....These beliefs are strongly influenced by the information that patients receive from health professionals and other sources....Feedback about the pilot guides [in the Medicines Information Project] showed that they help patients and their families. Designed and developed with both health professionals and patients and accessible online from anywhere in the world, these guides have advantages over mandatory patient information leaflets. They can be customised to provide only the information relevant to a specific indication; they discuss medicines in the context of all available alternatives, including non-drug options; and they link to relevant clinical information about conditions in NHS Direct Online. And because the guides are an online resource with open access, they can inform the dialogue between patients and health professionals when making treatment decisions. "

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