Received: 11 November 2017
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Accepted: 10 January 2018
DOI: 10.1002/prp2.387
ORIGINAL ARTICLE
Assessment of self-reporting reading of medicine’s labels and the resources of information about medicines in general public in Malaysia Omar T. Dawood1
| Mohamed A. Hassali2 | Fahad Saleem3 | Inas R. Ibrahim2
1 Department of Medical Services, Ministry of Science and Technology, Baghdad, Iraq 2
Abstract
Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
This study was undertaken to assess the people’s self-reported reading of medicine
3
Faculty of Pharmacy and Health Sciences, University of Baluchistan, Quetta, Pakistan
general public in the State of Penang, Malaysia. A total of 888 participants were
Correspondence Omar T. Dawood, Department of Medical Services, Ministry of Science and Technology, Baghdad, Iraq. Email:
[email protected]
was used to obtain the data from all the participants. Most of the participants
labels and its associated factors and to assess the sources of information about medicines among general public. A cross-sectional study was carried out among conveniently selected and completed the survey. A self-administered questionnaire (74.2%) reported that they have adequate information about medicines provided on their medicine labels. In addition, 86.9% of them reported that they read their medicine’s label for the directions of usage and 84.3% for the dosage instruction. However, 42.1% of the participants do not read their medicine’s label for the active ingredients, and 33% of them do not read their medicine’s label for the safety information. In addition, 36.5% of the respondents did not read the label of medicine for the symptoms which can be used for. However, females, Malay respondents, and higher education level (college/university) were more likely to self-reported the reading medicine’s label. Females were more likely to read the labels of medicines compared with males (OR = 1.6, 95% CI 1.20-2.13, P = .001). The reading of medicine labels was predicted by females, Malay respondents, and higher educated people. Health educational programs are needed to clarify label’s information that can help in concept of patient safety. KEYWORDS
medicine information, medicine labeling, perception, public
1 | INTRODUCTION
likely to misunderstand the information on medicine’s labels and package inserts, leading to misuse their medicines.3 In Malaysia,
Medicine labeling is an effective tool for providing important health 1
medicine label is structured to have the supplier name, patient’s
information for patients. The label of medicine was designed to
name, medicine name, the directions of using medicine, the date of
guide the consumers to know the ingredients of medicines, instruc-
obtaining medicine, and the registration number of medicine.1 Doc-
tions of dose, frequency, expiry date, storage method, and the
tors usually have no enough time to explain information about the
adverse effects.2 People who are unable to read the label were more
prescribed medicines to their patients as they are mostly providing
---------------------------------------------------------------------------------------------------------------------------------------------------------------------This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2018 The Authors. Pharmacology Research & Perspectives published by John Wiley & Sons Ltd, British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics. Pharmacol Res Perspect. 2018;e00387. https://doi.org/10.1002/prp2.387
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details about the illness or condition that the patients are complain-
backgrounds. This study was undertaken between September and
ing of them.4 Furthermore, information from pharmacists is also
November 2015. People who are able to read and write in Malay
inadequate.4,5 Consequently, many patients depend on written infor-
language were invited to participate in the survey. This study was
mation such as medicine’s label or medicine’s leaflet. Labeling of
approved by “Joint Ethics Committee of the School of Pharmaceuti-
medicines can help to educate the patients and contribute to avoid
cal Sciences, USM—Hospital Lam Wah Ee on Clinical Studies” (USM-
any potential misperceptions among them, especially when they
HLWE/IEC/2015 [0001]).
5
have been prescribed with more than one medicine.4 Labeling of medicines is a strong factor in building up a healthy community, and it also reflects the quality of prescribing and dis-
2.2 | Sampling and sample size
pensing in the community.6 In other words, the knowledge of medi-
A convenience sampling method was used to recruit the participants
cine in the community can be evaluated by the level of
from a household areas in the northeast of Penang Island. The par-
5,6
Previous study has shown
ticipants of this study were selected from urban areas. Cochran’s
that there is an association between higher levels of education or
equation was used to calculate the sample size in this survey and to
higher knowledge scores of medicines and better interpretation of
yield a representative sample for proportions.15 The sample size was
understanding their medicine’s labeling.
7
auxiliary labels. Reading the basic information of medicine labels is
calculated based on the confidence level of 95% and 5% of margin
an important factor for using medicine appropriately. Information on
of error. The required sample size was 377. By using the common
medicine labels is a main source of knowledge for patients to under-
design effect of 2, the required sample size was 769. In addition,
stand the risks and benefits of medicines and use them safely and
another 20% was added to our sample in case of missing and drop-
effectively.4,8
ping data, to be in total 923 participants. For the purpose of study,
Regarding the sources of information about medicines, a previ-
1000 people were invited to participate in this survey.
ous study reported that medicine information is often obtained from modern healthcare professionals, followed by the internet as a source of medicinal information as well. Doctors are the most com-
2.3 | Data collection
mon source of information at 61%, followed by pharmacist, 49% and
A self-administered questionnaire was used to assess public’s self-
nurse, 14%. Only 9% of the respondents choose internet as their
reported reading of information on medicine labels. The question-
source of medicine information.9 Another study showed that the
naire was developed based on previous studies relating to study
respondents from younger age groups have higher tendency to use
topic.14,16 The developed questionnaire was translated into Malay
information from internet as their source when it comes to look for
language by qualified linguistic translator and expert in the field of
10
However, some people are still have low
pharmacy practice to ensure the accuracy and clarity of the ques-
awareness regarding the ideal sources of information about medi-
tionnaire. The face and content validity were checked by 2 lecturers
cines.11 They are advised by their family or friends to try the treat-
from the School of Pharmaceutical Sciences, Universiti Sains Malay-
ment and very few of them will refer to doctors. The medicine
sia, and then was pretested and piloted with 45 respondents from
information resource is an important aspect for public to get access
the public to ensure the clarity of the questions. In addition, the
to better health.12 In general, the sources of information about
internal consistency of the questions was calculated using Cron-
medicines are physician and pharmacist. Patients are commonly
bach’s alpha which indicates an acceptable value of 0.918 for 6
tended to obtain information about medicines from various channels
items. The developed questionnaire consists of three parts. The first
medicine information.
12,13
However,
part was used for obtaining the socio-demographic information of
medicine information sources are a huge matter for patients to
the respondents. The second part includes questions on medicine
understand their medicine’s usage.14 This study will help to describe
labeling by focusing on the most information provided on the label
the common practices for obtaining medicine information among
of medicines. The last part includes questions about the sources of
general public in the State of Penang, Malaysia. The objectives of
information about medicines. The participants were visited house to
this study were to assess the perception of the general public
house in the residential area for data collection. After explaining the
toward the reading of medicine labels and to find the factors influ-
aim of the study, a self-administered questionnaire was used to
encing public’s perception on the reading of medicine labels, as well
obtain the data from participants. Most of the participants
as to describe the sources of information about medicines among
responded at the same time of distributing the questionnaires, while
general public.
some of them responded later and returned the questionnaire on
such as advertising, mass media, and the internet.
the next days. The questionnaire was completed within ~10 to
2 | MATERIALS AND METHODS
15 minutes.
2.1 | Study design
2.4 | Data analysis
Across-sectional survey was carried out among people aged over
The data were coded and analyzed using SPSS (version 18.0, SPSS
18 years old and above from both gender and different ethnic
Inc., Chicago, IL). Descriptive analysis including frequencies and
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percentages were used to describe the distribution of the responses.
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T A B L E 1 Socio-demographic information of the participants
For the self-reporting items, each item had 3 responses (“yes,”
Variable
“no,” and “not sure”). The scoring method was used for analysis.
Age group
Respondents who responded “yes” for self-reported reading of medicine label was given a score of 1, and the respondents who responded “no” or “not sure” for reading their medicine labels was given 0. The normality of total score was tested by using Kolmogorov-Smirnov test which indicated a skewed data (P
