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      How best to use and evaluate Patient Information Leaflets given during a consultation: a systematic review of literature reviews


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          In the past, several authors have attempted to review randomized clinical trials ( RCT) evaluating the impact of Patient Information Leaflets ( PILs) used during a consultation and draw some general conclusions. However, this proved difficult because the clinical situations, size and quality of RCTs were too heterogeneous to pool relevant data.


          To overcome this 30‐year stalemate, we performed a review of reviews and propose general recommendations and suggestions for improving the quality of PILs, how to use them and methods for evaluating them.


          We searched five databases for reviews, systematic reviews and meta‐analyses describing PILs. We drew general and condition‐linked conclusions concerning the impact of PILs. Checklists summarize criteria for quality PILs, and ways of using and evaluating them.


          Of 986 articles found, 24 reviews were pertinent; the five oldest considered the impact of PILs irrespective of the condition the patient consulted for; the 19 more recent ones mostly addressed precise clinical situations.


          Whatever the clinical situation, PILs improve patients' knowledge and satisfaction. For acute conditions, in the short‐term PILs also improve adherence to treatment. For chronic diseases, invasive procedures or screening situations, their impact on adherence varies depending on the context, how the PILs are given and the invasiveness of the intervention.


          PILs are considered to be very useful, especially for acute conditions where the patient is the first to suffer from lack of information. We propose checklists for writing, designing, using and evaluating PILs in RCTs to enable comparisons between different studies.

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          Most cited references 46

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          Interventions to enhance patient adherence to medication prescriptions: scientific review.

          Low adherence with prescribed treatments is ubiquitous and undermines treatment benefits. To systematically review published randomized controlled trials (RCTs) of interventions to assist patients' adherence to prescribed medications. A search of MEDLINE, CINAHL, PSYCHLIT, SOCIOFILE, IPA, EMBASE, The Cochrane Library databases, and bibliographies was performed for records from 1967 through August 2001 to identify relevant articles of all RCTs of interventions intended to improve adherence to self-administered medications. Studies were included if they reported an unconfounded RCT of an intervention to improve adherence with prescribed medications for a medical or psychiatric disorder; both adherence and treatment outcome were measured; follow-up of at least 80% of each study group was reported; and the duration of follow-up for studies with positive initial findings was at least 6 months. Information on study design features, interventions, controls, and findings (adherence rates and patient outcomes) were extracted for each article. Studies were too disparate to warrant meta-analysis. Forty-nine percent of the interventions tested (19 of 39 in 33 studies) were associated with statistically significant increases in medication adherence and only 17 reported statistically significant improvements in treatment outcomes. Almost all the interventions that were effective for long-term care were complex, including combinations of more convenient care, information, counseling, reminders, self-monitoring, reinforcement, family therapy, and other forms of additional supervision or attention. Even the most effective interventions had modest effects. Current methods of improving medication adherence for chronic health problems are mostly complex, labor-intensive, and not predictably effective. The full benefits of medications cannot be realized at currently achievable levels of adherence; therefore, more studies of innovative approaches to assist patients to follow prescriptions for medications are needed.
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            Improving the measurement of self-reported medication nonadherence: response to authors.

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              Sharing decisions with patients: is the information good enough?


                Author and article information

                Melanie.sustersic@gmail.com , AFoote@chu-grenoble.fr
                Health Expect
                Health Expect
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                26 September 2016
                August 2017
                : 20
                : 4 ( doiID: 10.1111/hex.2017.20.issue-4 )
                : 531-542
                [ 1 ] TIMC‐IMAG University of Grenoble Alpes Grenoble France
                [ 2 ] Groupe Hospitalier Mutualiste de Grenoble (GHM) Grenoble France
                [ 3 ] LIP/LPC2S, EA 4145 University of Grenoble Alpes Grenoble France
                [ 4 ] Inserm CIC 1406 Grenoble Alpes University Hospital Grenoble France
                Author notes
                [* ] Correspondence

                Mélanie Sustersic, Pavillon Taillefer, CHU, Grenoble, France.

                Emails: Melanie.sustersic@ 123456gmail.com ; AFoote@ 123456chu-grenoble.fr

                © 2016 The Authors. Health Expectations published by John Wiley & Sons Ltd

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 2, Tables: 3, Pages: 12, Words: 7407
                Review Article
                Review Articles
                Custom metadata
                August 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.4 mode:remove_FC converted:17.07.2017


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