Search Results (10)

Accessing and understanding medication information can be challenging for many people, especially when patient information leaflets (PILs) are long, complex, and printed in small font. This study presents MediChat, an open-source, locally executable chatbot designed to provide reliable, easy-to-read answers to medication-related questions based exclusively on official PILs. MediChat follows a retrieval-augmented generation (RAG) architecture: PILs from the Austrian Medicinal Product Index are received via API, converted to text, split into overlapping chunks, embedded, and stored in a Chroma vector database. From there the top-k relevant chunks are retrieved, and Llama 3.1 generates German responses based on this evidence. The system was evaluated using a hybrid framework. Quantitatively, 200 yes/no questions across ten drugs were answered with 80% accuracy, overall precision 0.977, recall 0.686, F1-score 0.806, and a mean response time of 727 ms. Qualitatively, two personas were used in eight simulated dialogues. Response times were around 1.1–1.3 s, and task completion exceeded 85% with high ratings for relevance and quantity. These results indicate that an open-source RAG chatbot can deliver leaflet-grounded, user-friendly medication information and provide a reproducible template for future healthcare chatbot evaluations. Full article

People with intellectual disabilities frequently use psychotropic and other medications, sometimes inappropriately. To promote shared decision-making, they require accessible information about their medication. This study combined data from two similar intervention studies, conducted in two different settings, to assess the appropriateness of medication use and the shared decision-making process among adults with mild intellectual disabilities who used psychotropic medication. The intervention consisted of a structured, multidisciplinary medication review, including the provision of accessible psychotropic medication leaflets, and a discussion of the pharmacotherapeutic treatment plan with the patient by either a pharmacist or physician, depending on the setting. Outcomes included medication use, pharmacotherapeutic problems, implementation of recommendations, and perceived shared decision-making, measured with the Shared Decision-Making Questionnaire Q9. The 15 included participants used an average of nearly seven medications, which were mainly neurotropic, gastrointestinal, cardiovascular, and respiratory agents. On average, two pharmacotherapeutic problems were identified; the most common were overtreatment, side effects, and administration difficulties. Recommendations often involved dose reduction or tapering, and about 75% were fully or partially implemented. Both participants and clinicians reported high satisfaction with shared decision-making. Multidisciplinary, structured medication reviews, incorporating accessible medication leaflets, may enhance appropriate medication use and shared decision-making, but more research is needed. Full article

Background/Objectives: Existing patient information leaflets (ePILs), mandated by the FDA to accompany new prescriptions, are difficult to read and understand due to their complexity and poor visual design, especially for populations with low health literacy and low English proficiency. In this study, we developed infographic-based PILs (iPILs) with a concise question-and-answer format, emphasizing essential information, as specified by the FDA. This study compared iPILs and ePILs using the 5C factors: comprehension, cosmetics, convenience, content, and credibility, as perceived by English-speaking and Spanish-speaking populations. Methods: This multicenter, experimental survey study assessed the 5C factors. English and Spanish-speaking adults on ≥1 chronic medication were recruited from community pharmacies in California (CA) and Illinois (IL). They were stratified to review either an ePIL or an iPIL for one of four common medications. They completed a Medication Knowledge Quiz (MKQ) to show their comprehension using six open-ended questions. Subsequently, they received both PIL versions and answered preference questions about the 4C and media format and, lastly, about demographic and health literacy questions. Results: A total of 235 participants completed the surveys at three sites (CA-English, CA-Spanish, and IL-English), with differing participant characteristics. The CA-Spanish participants scored the lowest on health literacy and the number of health conditions. The MKQ scores for those using the iPILs were significantly higher than for those using the ePILs across all groups. They significantly correlated with health literacy results for the ePILs (r = 0.394, p < 0.001). The participants preferred the iPILs over the ePILs for four of the C factors, barring one content question. Regardless of age, printed formats were preferred (64.7%)—alone or with digital formats (21.3%)—over digital formats alone (3.4%). Overall, 79.1% of the participants preferred iPILs, 11.9% preferred ePILs, and 8.9% preferred either version. Conclusions: The infographic-based patient information leaflets (iPILs) were easier to read, navigate, and understand, making them more accessible to individuals with varying levels of health literacy. Infographic-based leaflets outperformed existing ones in user comprehension and were preferred due to their simple layout, ease of navigation, and helpfulness. Full article

The advancement of medical 3D printing technology includes several enhancements, such as decreasing the length of surgical procedures and minimizing anesthesia exposure, improving preoperative planning, creating personalized replicas of tissues and bones specific to individual patients, bioprinting, and providing alternatives to human organ transplants. The range of materials accessible for 3D printing within the healthcare industry is significantly narrower when compared with conventional manufacturing techniques. Liquid silicone rubber (LSR) is characterized by its remarkable stability, outstanding biocompatibility, and significant flexibility, thus presenting substantial opportunities for manufacturers of medical devices who are engaged in 3D printing. The main objective of this study is to develop, refine, and assess a 3D printer that can employ UV-cured silicone for the fabrication of aortic heart valves. Additionally, the research aims to produce a 3D-printed silicone aortic heart valve and evaluate the feasibility of the final product. A two-level ANOVA experimental design was utilized to investigate the impacts of print speed, nozzle temperature, and layer height on the print quality of the aortic heart valve. The findings demonstrated that the 3D-printed heart valve’s UV-cured silicone functioned efficiently, achieving the target flow rates of 5 L/min and 7 L/min. Two distinct leaflet thicknesses (LT) of the heart valve, namely 0.8 mm and 1.6 mm, were also analyzed to simulate calcium deposition on the leaflets. Full article

Patient information leaflets (PILs) are essential tools in healthcare, providing crucial information about medication use. In the European Union, the European Medicines Agency (EMA) oversees the regulation and standardisation of PILs to ensure their readability and accessibility. However, challenges persist in ensuring these documents are comprehensible and user-friendly. This study employs a qualitative analytical approach, reviewing existing literature and regulatory documents to identify gaps in the EU user testing policies for PILs. It focuses on the diversity of participant samples, the independence of the testing process, and the robustness of user testing protocols. Findings indicate that current user testing practices often lack diversity and may be biased when pharmaceutical companies conduct their own tests. Additionally, there is a lack of user testing protocols for translated PILs, potentially compromising their accuracy and cultural relevance. To improve the efficacy of PILs, it is essential to include diverse and representative samples in user testing, mandate independent third-party evaluations, implement protocols for user testing on translated PILs, and ensure continuous updates to guidelines based on the latest best practices in health communication. These measures will enhance patient safety and understanding of medication information. Full article

Background and Aim: Women in Oman and low- and middle-income countries (LMICs) are usually diagnosed with BC at a younger age and more advanced stage, with poor five-year survival. This study aims to evaluate the effectiveness of breast cancer (BC) related educational programs among female Omani adolescents. Materials and Methods: Six female-only public schools were randomly selected from three governorates of Oman and assigned to the control or interventional group. An Arabic version of the Breast Cancer Awareness Measure questionnaire was used to evaluate students attending grades 10 and 11 at baseline (T0) and after 4 weeks (T1). After T0, the intervention group participated in a one-hour BC education program involving group discussions, a slideshow presentation, leaflets, and online access to program materials and videos. Non-parametric tests were used to compare scores between intervention and control groups and within each group across time (T0 vs. T1). Results: A total of 1106 students participated, of which 547 (49.5%) and 559 (50.5%) were allocated to the control and intervention groups, respectively. Recognition of BC risk factors (Z = 18.67; p < 0.001) and symptoms (Z = 20.01; p < 0.001) increased significantly in the intervention group between T0 and T1 and compared to the control group at T1 (U = 27.27; p < 0.001, and U = 25.75; p < 0.001, respectively). Anticipated time to seeking medical help (Z = 18.67; p < 0.001) and barriers to help-seeking (Z = 7.91; p < 0.001) decreased significantly between T0 and T1 in the intervention group and compared to the control group at T1 (U = 15.78; p < 0.001, and U = 3.44; p = 0.001, respectively). Conclusion: The program increased knowledge of BC risk factors and symptoms and promoted early medical help-seeking among Omani female adolescents. Healthcare strategic planners and policy-makers in Oman and low- and middle-income countries should consider incorporating cancer education programs in the national school curriculum to minimize delays in BC diagnosis and improve the survival rate. Full article

A Teratology Information Service (TIS) does not exist in Belgium yet but will hopefully be established soon. To prepare for this, we aimed to provide insight into the information needs and counseling preferences of the Belgian public and healthcare professionals (HCPs) regarding medication use in pregnancy and breastfeeding. A cross-sectional study using two anonymous, online surveys disseminated via social media, websites, and newsletters addressing Dutch and French-speaking individuals (≥18 years) and licensed HCPs was performed between June and September 2020. Ethics approval and informed consent were obtained. In total, 1508 public survey respondents (98% women) and 702 HCPs participated. Information needs on perinatal medication use were ubiquitous among both groups, and for which they often relied on patient information leaflets or the product information and online fora. Conflicting information on this topic regularly occurs and complicates HCPs’ duties. Women and HCPs assigned an important role to a TIS, both in terms of providing evidence-based information (via a website or app) and being accessible to be contacted in case of questions (by phone or via e-mail or chat). In conclusion, a TIS would be warmly welcomed by women and HCPs in Belgium and should ideally be established soon to address current information needs regarding perinatal medication use and to contribute to research in this field. Full article

This paper evaluates India’s first officially approved self-administered rapid antigen test kit against COVID-19, a device called CoviSelf. The context is rural India. Rapid antigen tests (RATs) are currently popular in situations where vaccination rates are low, where sections of the community remain unvaccinated, where the COVID-19 pandemic continues to grow and where easy or timely access to RTPCR (reverse transcription-polymerase chain reaction) testing is not an option. Given that rural residents make up 66% of the Indian population, our evaluation focuses on the question of whether this self-administered RAT could help protect villagers and contain the Indian pandemic. CoviSelf has two components: the test and IT (information technology) parts. Using discourse analysis, a qualitative methodology, we evaluate the practicality of the kit on the basis of data in its instructional leaflet, reports about India’s ‘digital divide’ and our published research on the constraints of daily life in Indian villages. This paper does not provide a scientific assessment of the effectiveness of CoviSelf in detecting infection. As social scientists, our contribution sits within the field of qualitative studies of medical and health problems. Self-administered RATs are cheap, quick and reasonably reliable. Hence, point-of-care testing at the doorsteps of villagers has much potential, but realising the benefits of innovative, diagnostic medical technologies requires a realistic understanding of the conditions in Indian villages and designing devices that work in rural situations. This paper forms part of a larger project regarding the COVID-19 pandemic in rural India. A follow-up study based on fieldwork is planned for 2022–2023. Full article

The integration of face-to-face communication and online processes to provide access to information and self-assessment tools may improve shared decision-making (SDM) processes. We aimed to assess the effectiveness of implementing an online SDM process with topics and content developed through a participatory design approach. We analyzed the triggered and completed SDM cases with responses from participants at a medical center in Taiwan. Data were retrieved from the Research Electronic Data Capture (REDCap) database of the hospital for analysis. Each team developed web-based patient decision aids (PDA) with empirical evidence in a multi-digitized manner, allowing patients to scan QR codes on a leaflet using their mobile phones and then read the PDA content online. From July 2019 to December 2020, 48 web-based SDM topics were implemented in the 24 clinical departments of this hospital. The results showed that using the REDCap system improved SDM efficiency and quality. Implementing an online SDM process integrated with face-to-face communication enhanced the practice and effectiveness of SDM, possibly through the flexibility of accessing information, self-assessment, and feedback evaluation. Full article

In Germany, asylum seekers and refugees (AS&Rs) face challenges when accessing healthcare services including medicines. The aim of this study was to explore the barriers to accessing medicines among Syrian AS&Rs in the state of North Rheine-Westphalia, and to provide an understanding of their perspectives towards taking medicines that contain alcohol or pork products. This study is based on a cross-sectional survey using a combination of sampling methods. We used descriptive statistics to analyze quantitative data. Participants’ answers to an open-ended question yielded qualitative data that were categorized based on the thematic areas they discussed or addressed. Among the 1641 respondents, language barriers had more of an effect on the access to medicines than any other factor studied. The effect of language barriers on access to medicines was more pronounced for female participants, those who were older than 50 years, and participants who had chronic diseases in comparison to the other groups of participants. Male participants and those younger than 50 years of age showed more acceptance towards taking medicines that contain alcohol or pork products. Based on our results, we recommend providing more support for AS&Rs to learn the German language, particularly for female refugees, older refugees, and those with chronic diseases or disabilities. We also recommend providing translated medical leaflets for patients who wish to receive them in their native language. Healthcare providers should try to consider the special conditions of AS&Rs patients and take into account their perspectives about treatments and diseases. Full article