Home' Australian Journal of Pharmacy : Jan Feb 2015 Contents T
he main basis of chronic
disease state management
is lifestyle modification
complemented by drug
treatment, but people may decide
whether to start or continue with
recommended treatment.1 The factors
that influence drug taking are many
and this topic is highly controversial.
‘How much to tell a patient, or
their family, or not?’
‘What do they want to know?’
‘What do they need to know?’
‘What about litigation?’
This article aims to raise some of
the issues, concerns, behavioural
reactions and controversies but
cannot give the answers, as the simple
answer is ‘It depends...’.
As the efficacy of a drug is central
to the decision to start or continue
treatment, accurate and concise
communication of the benefits
of treatment is usually offered by
The disadvantages and adverse
effects of drugs are also important
and are usually conveyed by
pharmacists at the point of
dispensing or when the consumer
reads about them in the Consumer
Medicines Information (CMI), on
the internet or hears about them
via the media. Concerns about
adverse drug reactions (ADRs), the
noxious and unintended effects
of a drug, can deter patients from
starting treatment, while their
occurrence during treatment can
Accurate information about
ADRs and its communication
to patients is likely to influence
the outcomes of chronic disease
state management.6 The words,
adverse drug reactions, adverse
effects and side effects are
used interchangeably by health
professionals and texts vary, as does
the perception by the individual
of the severity of the drug effect.
Table 1 defines the terminology
used to describe drug effects.
What we mean and how the
person interprets our language is
vital and even more of a concern for
people with English as their second
language and variable health literacy.
The Safety and Quality Council
of Australia has produced a Health
Literacy National Statement which
CONCERNS ABOUT HOW MUCH AND WHAT
INFORMATION TO GIVE A PERSON DEPENDS ON
THE ASSESSMENT OF THE NEEDS OF THE PERSON
AND THEIR ABILITY TO ASSESS INFORMATION,
BUT ALSO THE NEED TO PREVENT HARM.
After reading this article, the
learner should be able to:
• communicate with patients the
differences between side effects
and adverse drug reactions;
• recognise health literacy and
• discuss the influence of media
hype on patient behaviour;
• recognise the impact of the
placebo and nocebo effects;
• optimise adherence with
• avoid the risk of litigation from
1.3, 2.1, 2.2, 2.3, 4.1, 4.2, 7.1, 7.2,
Education DISEASE STATE MANAGEMENT
▲ Dr Jenny Gowan PhD, Grad Dip Comm Pharm, FPS, FACPP, AACPA, consultant pharmacist, MediCom Medication Management Services; teaching associate, Faculty of Pharmacy and
Pharmaceutical Sciences, Monash University; Australian Pharmacist of the year 2013. Associate Professor Louis Roller PhD, MSc, BPharm, BSc, DipEd, FPS, FACPP, teaching associate,
Faculty of Pharmacy and Pharmaceutical Sciences, Monash University.
Communicating the harmful
effects of medication
Accreditation number: CX140077
Upon successful completion of the
corresponding assessment, this
activity has been accredited for1.25
hours of Group 2 CPD (or 2.5 CPD
credits) suitable for inclusion on an
individual pharmacist’s CPD plan.
‘Warnings may have unintended consequence’
64 | THE AUSTRALIAN JOURNAL OF PHARMACY VOL.96 JANUARY/FEBRUARY 2015
THE AUSTRALIAN JOURNAL OF PHARMACY VOL.96 JANUARY/FEBRUARY 2015 | 65
Table 1: Terminology of drug effects1,6,7
A secondary effect of a drug that might be adverse or beneficial.
An untoward occurrence in response to administration of a drug, which does not necessarily have a
causal relation with the treatment.
Adverse drug reaction
A response to a drug that is noxious and unintended and that occurs at doses normally used for
prophylaxis, diagnosis, or treatment of disease or for modification of physiological function.
A measure of the degree of harmfulness of an adverse response to a drug.
A measure of the intensity of an adverse response to a drug.
A beneficial effect produced by positive expectations.
An adverse effect produced by negative expectations.
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