Communicating information about medication side effects: effects on satisfaction, perceived risk to health, and intention to comply

Previous research has shown that people's evaluations of explanations about medication and their intention to comply with the prescription are detrimentally affected by the inclusion of information about adverse side effects of the medication. The present study (Experiment 1) examined which particular aspects of information about side effects (their number, likelihood of occurrence, or severity) are likely to have the greatest effect on people's satisfaction, perception of risk, and intention to comply, as well as how the information about side effects interacts with information about the severity of the illness for which the medication was prescribed. Across all measures, it was found that manipulations of side effect severity had the greatest impact on people's judgements, followed by manipulations of side effect likelihood and then number. Experiments 2 and 3 examined how the severity of the diagnosed illness and information about negative side effects interact with two other factors suggested by Social Cognition models of health behaviour to affect people's intention to comply: namely, perceived benefit of taking the prescribed drug, and the perceived level of control over preventing or alleviating the side effects. It was found that providing people with a statement about the positive benefit of taking the medication had relatively little effect on judgements, whereas informing them about how to reduce the chances of experiencing the side effects had an overall beneficial effect on ratings.

Is 15 per cent very common? Informing people about the risks of medication side effects

Objectives - To assess the general public's interpretation of the verbal descriptors for side effect frequency recommended for use in medicine information leaflets by a European Union (EU) guideline, and to examine the extent to which differences in interpretation affect people's perception of risk and their judgments of intention to comply with the prescribed treatment. Method - Two studies used a controlled empirical methodology in which people were presented with a hypothetical, but realistic, scenario about visiting their general practitioner and being prescribed medication. They were given an explanation that focused on the side effects of the medicine, together with information about the probability of occurrence using either numerical percentages or the corresponding EU verbal descriptors. Interpretation of the descriptors was assessed. In study 2, participants were also required to make various judgments, including risk to health and intention to comply. Key findings - In both studies, use of the EU recommended descriptors led to significant overestimations of the likelihood of particular side effects occurring. Study 2 further showed that the "overestimation" resulted in significantly increased ratings of perceived severity of side effects and risk to health, as well as significantly reduced ratings of intention to comply, compared with those for people who received the probability information in numerical form. Conclusion - While it is recognised that the current findings require replication in a clinical setting, the European and national authorities should suspend the use of the EU recommended terms until further research is available to allow the use of an evidence-based approach.

Donald Broadbent : 12th annual Broadbent lecture

In the 12th annual Broadbent Lecture at the Annual Conference Dianne Berry outlined Broadbent’s explicit and implicit influences on psychological science and scientists.

Transfer effects in implicit memory and consumer choice

Two experiments investigated transfer effects in implicit memory and consumer choice, using a preference judgement task. Experiment 1 examined whether it is possible to obtain priming for unfamiliar food labels. Additionally, it investigated whether the experience of seeing a brand name with a particular product type would benefit subsequent processing of the brand name when linked with a different product type. Experiment 2 examined whether changes in modality between study and test would affect priming for unfamiliar brand names. Both questions are theoretically important, as well as pertaining to practical concerns in the consumer choice literature. Experiment 1 demonstrated significant priming for unfamiliar food labels, and established that priming was unaffected by changing the product type with which the brand name was associated. In Experiment 2, priming on both auditory and visual versions of the preference judgement task was reduced by changes in modality. The results and implications are discussed in relation to consumer choice and current theories of implicit memory.

Implicit memory: intention and awareness revisited

One of the major developments in memory research in the past decade or so has been a growing interest in implicit memory – task performance that is not accompanied by conscious or intentional recollection. In this article, we examine evidence for perceptual and conceptual implicit memory, using the accepted definitions, and suggest that there is in fact a lack of strong evidence for implicit memory in normal subjects. If more convincing evidence cannot be obtained, one solution might be to modify the current terminology. We suggest that the term implicit memory might have outgrown its usefulness as an overall descriptor.

Gender stereotyping and decision processes: extending and reversing the gender bias in fame judgements

M. R. Banaji and A. G. Greenwald (1995) demonstrated a gender bias in fame judgments—that is, an increase in judged fame due to prior processing that was larger for male than for female names. They suggested that participants shift criteria between judging men and women, using the more liberal criterion for judging men. This "criterion-shift" account appeared problematic for a number of reasons. In this article, 3 experiments are reported that were designed to evaluate the criterion-shift account of the gender bias in the false-fame effect against a distribution-shift account. The results were consistent with the criterion-shift account, and they helped to define more precisely the situations in which people may be ready to shift their response criterion on an item-by-item basis. In addition, the results were incompatible with an interpretation of the criterion shift as an artifact of the experimental situation in the experiments reported by M. R. Banaji and A. G. Greenwald. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Learning a procedural task: effectiveness of multimedia presentations

Three experiments investigated the effectiveness of presenting procedural information through different media and their combinations. Experiment 1 examined the effectiveness of text, line drawings, text and line drawings, video. and video stills for learning a first aid task. The results showed an advantage of text and line drawings and of the video presentation over the other three conditions for both bandaging performance and answering questions about the task. Experiment 2 showed that the beneficial effect of the combination of text and pictures could not be accounted for simply in terms of a dual coding explanation. Rather, the effectiveness of the media and their combinations was influenced by the extent to which they conveyed action information. Finally, Experiment 3 showed no evidence of a contiguity effect: text and pictures were as effective when presented together on the same screen as when they were presented separately. Copyright © 2000 John Wiley & Sons, Ltd.

Strengthening argumentation in medical explanations by text planning revision

Explanations are an important by-product of medical decisionsupport activities, as they have proved to favour compliance and correct treatment performance. To achieve this purpose, these texts should have a strong argumentation content and should adapt to emotional, as well as to rational attitudes of the Addressee. This paper describes how Rhetorical Sentence Planning can contribute to this aim: the rulebased plan discourse revision is introduced between Text Planning and Linguistic Realization, and exploits knowledge about the user personality and emotions and about the potential impact of domain items on user compliance and memory recall. The proposed approach originates from analytical and empirical evaluation studies of computer generated explanation texts in the domain of drug prescription. This work was partially supported by a British-Italian Collaboration in Research and Higher Education Project, which involved the Universities of Reading and of Bari, in 1996.

Evaluating explanations about drug prescriptions: effects of varying the nature of information about side effects and its relative position in explanations

This study evaluates computer-generated written explanations about drug prescriptions that are based on an analysis of both patient and doctor informational needs. Three experiments examine the effects of varying the type of information given about the possible side effects of the medication, and the order of information within the explanation. Experiment 1 investigated the effects of these two factors on people's ratings of how good they consider the explanations to be and of their perceived likelihood of taking the medication, as well as on their memory for the information in the explanation. Experiment 2 further examined the effects of varying information about side effects by separating out the contribution of number and severity of side effects. It was found that participants in this study did not “like” explanations that described severe side effects, and also judged that they would be less likely to take the medication if given such explanations. Experiment 3 therefore investigated whether information about severe side effects could be presented in such a way as to increase judgements of how good explanations are thought to be, as well as the perceived likelihood of adherence. The results showed some benefits of providing additional explanatory information.

Habituation and dishabituation to speech and office noise

The authors examined whether background noise can be habituated to in the laboratory by using memory for prose tasks in 3 experiments. Experiment 1 showed that background speech can be habituated to after 20 min exposure and that meaning and repetition had no effect on the degree of habituation seen. Experiment 2 showed that office noise without speech can also be habituated to. Finally, Experiment 3 showed that a 5-min period of quiet, but not a change in voice, was sufficient to partially restore the disruptive effects of the background noise previously habituated to. These results are interpreted in light of current theories regarding the effects of background noise and habituation; practical implications for office planning are discussed.

What do patients want to know about their medicines, and what do doctors want to tell them?: a comparative study

A two phase study is reported. In the first phase, we asked a number of doctors to rate a list of information categories (identified by Berry, Gillie and Banbury 1995) in terms of how important they felt it was for the items to be included in an explanation to a patient about a drug prescription. In the second phase, we presented a large sample of people with a scenario about visiting their doctor and being prescribed medication, together with an explanation about the prescription which was said to be provided by the doctor. Four different explanations were compared, which were either based on what people in our earlier study wanted to know about drug prescriptions or on what the doctors thought it was important lo tell them. We also manipulated whether or not the explanations conveyed negative information (e.g. about the possible side effects of the medication). The results showed that people 'preferred' the explanations based on what the participants in the earlier study wanted to know about their medicines, rather than those based on what the doctors thought they should be told. They also 'preferred' the explanations that did not convey negative information, rather than those that did convey some negative information. In addition, the inclusion of negative information affected ratings of likely compliance with the prescribed medication.

Implicit learning: Below the subjective threshold?

In this review, we consider three possible criteria by which knowledge might be regarded as implicit or inaccessible: It might be implicit only in the sense that it is difficult to articulate freely, or it might be implicit according to either an objective threshold or a subjective threshold. We evaluate evidence for these criteria in relation to artificial grammar learning, the control of complex systems, and sequence learning, respectively. We argue that the convincing evidence is not yet in, but construing the implicit nature of implicit learning in terms of a subjective threshold is most likely to prove fruitful for future research. Furthermore, the subjective threshold criterion may demarcate qualitatively different types of knowledge. We argue that (1) implicit, rather than explicit, knowledge is often relatively inflexible in transfer to different domains, (2) implicit, rather than explicit, learning occurs when attention is focused on specific items and not underlying rules, and (3) implicit learning and the resulting knowledge are often relatively robust.

Transfer across form and modality in implicit and explicit memory

Three experiments examined transfer across form (words/pictures) and modality (visual/ auditory) in written word, auditory word, and pictorial implicit memory tests, as well as on a free recall task. Experiment 1 showed no significant transfer across form on any of the three implicit memory tests,and an asymmetric pattern of transfer across modality. In contrast, the free recall results revealed a very different picture. Experiment 2 further investigated the asymmetric modality effects obtained for the implicit memory measures by employing articulatory suppression and picture naming to control the generation of phonological codes. Finally, Experiment 3 examined the effects of overt word naming and covert picture labelling on transfer between study and test form. The results of the experiments are discussed in relation to Tulving and Schacter's (1990) Perceptual Representation Systems framework and Roediger's (1990) Transfer Appropriate Processing theory.