The experience of the pandemic provides an unprecedented opportunity for engaging the public in a concerted education and information campaign to explain the role of medicines and vaccines: how they are developed, used, regulated and monitored for safety.
The aim would be to create a “pharmacy-literate” public. A parallel could be drawn with efforts to improve “financial literacy”.
The pandemic has exposed the UK population’s lack of a solid base-level education about medicines and vaccines, compounded by disparate and inconsistent sources of information. During the past year we have witnessed the resulting knowledge gap being filled with conspiracy theories and misinformation, spread primarily via social media. The MMR controversy of the late 1990s is another example of how easily false assertions can gain traction and cause fear amongst a public that is lacking in basic knowledge of the subject.
Greater public understanding of medicines and vaccines will assist the UK Government, its devolved administrations and health systems to:
• Debunk misinformation and myths around vaccines in particular – aiding efforts to overcome “vaccine hesitancy” and boost public confidence in the regulation of medicines.
• Encourage patients and carers to engage with regulators and the wider health system to report issues of safety and other concerns – strengthening the public’s input to the data collected to monitor the safety of medicines and vaccines and building trust in the role of the regulators.
• Support citizens to take responsibility for their own health management by empowering them to make informed choices and decisions – contributing to a healthier population and relieving pressure on the NHS.
• A better informed and educated public would, arguably, be more willing to participate in health research and clinical trials – supporting efforts to position ‘UK PLC’ as a prime location to develop innovative medicines and treatments.
There will be challenges in how to create an education and information programme that is:
• Trusted (by the public).
• Accessible (to all UK citizens).
• Comprehensive (in terms of its content).
Meeting those Challenges:-
Involving the right stakeholders to co-create the programme and to collaborate in its dissemination will help to ensure comprehensive content and, crucially, to build public trust in relation to both the information delivered and the overall aims.
Key stakeholders to involve include:
• Patient groups – from across the UK
• Black and Minority Ethnic (BAME) community groups
• UK Regulators – primarily the Medicines and Healthcare products Regulatory Agency (MHRA), the Health Research Authority and NICE
• NHS and public health bodies (e.g. the National Institute for Health Protection)
• Community Pharmacists – the networks/representative bodies for community pharmacists across the UK
• Other healthcare professional networks and Royal Colleges – those with direct relevance, such as the Royal College of General Practitioners
• Department for Education
Representatives from UK patient and BAME groups should be at the heart of the development and delivery of the programme. From the outset they should be involved in defining and steering the work. The inclusion of BAME community and patient group representatives will help to engender public trust.
Those stakeholders who represent the health and education systems, healthcare professionals and the regulators would be able to contribute technical content for the programme and the creation of dedicated information resources.
There could be a limited role for the pharmaceutical industry, primarily in relation to content development and perhaps a contribution to funding. However, caution would have to be exercised regarding the extent of industry participation in order to avoid public perception of the programme being used as a “vehicle” to market pharmaceutical products.
Making the programme accessible to the wider UK public will require a combination of the most appropriate delivery methods and support from the stakeholders – the latter can provide channels for dissemination through their own networks and communications; directly reaching out to patients and BAME communities.
A blend of different access points should be considered:
• Interactive electronic information terminals in every pharmacy and waiting room (GP surgeries, health centres and hospitals) – enabling patients and carers to access information, in a healthcare setting, about the medicines they are being prescribed and how to report side effects and other concerns.
• The National Curriculum would benefit from including the subject of medicines and vaccines (basic coverage of how they are developed, regulated and deployed) in the citizenship programme for key stage 4.
• A single trusted online source of information on medicines and vaccines that is independent of existing NHS and Government websites. A dedicated website could provide the public with very basic top level information on medicines and vaccines, whilst also allowing visitors to drill down into as much further detail as they wish:
o The top level should be composed of engaging content: simple in structure and delivered primarily in graphical format.
o Layers below can provide relevant health, technical and regulatory information and data, for those who wish to delve deeper.
• Regular blogs and podcasts from high-profile contributors could deliver “Pharma Facts” – myth-busting and fact-checking similar to those articles produced by the BBC health correspondents during the pandemic.
• A schedule of open public webinars that will deliver topical information on medicines and vaccines and will enable the audience to ask questions and explore topics with experts from the programme’s key stakeholders. The ‘ZOE Covid Symptom Study’ project has regularly run this type of webinar.
Co-ordination and Delivery:-
The MHRA, as the UK regulator for medicines and vaccines, could be ideally placed to lead and co-ordinate the overall programme and be given the additional resource this will require. The MHRA has an existing patient group forum which could be used to obtain initial input from patient representatives. It also has experience of bringing together stakeholders from across the wider health system, healthcare professions and patient groups, in order to address medicines’ safety issues. This could provide the basis for establishing a steering committee to define and oversee development of a concerted programme that enables the UK public to become “pharmacy-literate”.