Transcript Multimedia educational interventions for consumers about

Multimedia educational interventions
for consumers about prescribed and
over-the-counter medications
Clinical
www.cochranejournalclub.com
Clinical question
• Do multimedia patient education interventions about
prescribed and over-the-counter medications
improve outcomes in people of all ages, including
children and carers, in comparison with usual care or
other forms of education?
Source: Ciciriello S, Johnston RV, Osborne RH, Wicks I, deKroo T, Clerehan R, O'Neill C,
Buchbinder R. Multimedia educational interventions for consumers about prescribed and
over-the-counter medications. Cochrane Database of Systematic Reviews 2013, Issue 4.
Art. No.: CD008416. DOI: 10.1002/14651858.CD008416.pub2.
www.cochranejournalclub.com
2
Context
• Health consumers increasingly want access to
accurate, evidence-based information about their
medications.
• Currently, education about medications is provided
predominantly by spoken communication from
healthcare providers, supplemented with written
materials.
• There is evidence that current educational methods
are not meeting consumer needs.
• Multimedia educational programs offer potential
advantages over traditional forms of education
delivery.
www.cochranejournalclub.com
3
Methods
• The Cochrane Central Register of Controlled Trials,
MEDLINE, EMBASE ,CINAHL, PsycINFO, ERIC and
Proquest Dissertation and Theses Databases were
searched, and the reference lists of included studies
and relevant review articles were checked.
• Effects were expressed as risk ratios (RR) for
dichotomous outcomes and mean differences (MD)
for continuous outcomes, unless studies used
different scales to measure the same outcome, when
the standardised mean difference (SMD) was used.
www.cochranejournalclub.com
4
PICO(S) to assess eligible studies
• Participants: People of all ages, including children and
carers.
• Intervention: Multimedia patient education about
prescribed or over-the-counter medications.
• Comparison: No education, usual care (non-standardised
education provided as part of usual health care), other
forms of education or control multimedia programs
(programs that did not contain information about the
medication).
• Primary outcomes: Knowledge and skill acquisition.
• Studies: Randomised trials and quasi-randomised trials.
www.cochranejournalclub.com
5
Description of eligible studies
• 24 studies that enrolled a total of 8112 participants met the
inclusion criteria.
• There was wide variation in the comparators used and the
outcomes measured, which limited the ability to pool data.
• 10 studies compared multimedia education to usual care or no
education, five studies compared it to written education, six to
verbal education by a health professional, three to a control
multimedia program and six compared the combination of a
multimedia education program with a co-intervention versus the
co-intervention alone.
• Three studies had a high risk of selection bias and one was at
high risk of bias due to lack of blinding of the outcome assessors.
www.cochranejournalclub.com
6
Results: knowledge
• Multimedia education versus usual care or no education
Low quality evidence in favour of multimedia education (SMD
1.04, 95% CI 0.49 to 1.58, 6 studies, 817 participants)
• Multimedia education versus a control multimedia program
Moderate quality evidence that multimedia education was not
more effective (MD [knowledge scores] 2.8%, 95% CI -1.5 to 7.0, 2
studies, 568 participants)
• Multimedia education with written education or brief verbal
instructions from a healthcare professional versus cointervention alone
Moderate quality evidence that multimedia education was more
effective (MD [knowledge scores] 24.6%, 95% CI 22.3 to 26.8, 2
studies, 381 participants)
www.cochranejournalclub.com
7
Results: skill acquisition
• Multimedia education versus usual care or no education
Moderate quality evidence in favour of multimedia education
(MD [inhaler technique score] 18.3%, 95% CI 11.9 to 24.7, 2
studies, 94 participants)
• Multimedia education versus written education
Moderate quality evidence in favour of multimedia education
(RR [improved inhaler technique] 2.14, 95% CI 1.33 to 3.44, 2
studies, 164 participants)
• Multimedia education versus education by a healthcare
professional
Very low quality evidence that multimedia education was
equally effective (MD [inhaler technique score] -1.0%, 95% CI 15.8 to 13.7, 3 studies, 130 participants).
www.cochranejournalclub.com
8
Results: other outcomes
• Compliance with medications
Moderate quality evidence that there was no
difference between multimedia education and usual
care or no education (RR [compliance] 1.02, 95% CI
0.96 to 1.08, 2 studies, 4552 participants)
• Too little data to draw conclusions on other
outcomes, including patient satisfaction, selfefficacy and health outcomes.
www.cochranejournalclub.com
9
Conclusions
• Multimedia education about medications is more
effective than usual care or no education, in
improving both knowledge and skill acquisition.
• Multimedia education is at least equivalent to other
forms of education, including written education and
education provided by a healthcare professional;
based on low quality evidence from few trials.
• Conclusions were limited by the lack of information
about the educational interventions, variability in
their content and quality and heterogeneity in the
measurement and reporting of outcomes.
www.cochranejournalclub.com
10
Useful links
• Cochrane Journal Club discussion points
• Multimedia educational interventions for
consumers about prescribed and overthe-counter medications
www.cochranejournalclub.com
11