- The Washington Times - Sunday, May 5, 2002

Plaudits to the over-the-counter medicine industry and its regulators.Manufacturers, usually at competitive odds, have joined with each other and the Food and Drug Administration to give the country a well-designed, informative label backed by a solid public education campaign. The goal: to lead consumers to wise purchases that are used well.
This is no small challenge. Americans shell out more than $19.1 billion a year for 5 billion painkillers, cold medicines, antacids and other health-care products that do not need physicians' orders. They are serious drugs that can do harm if taken incorrectly. Yet most consumers don't know the active ingredients in the OTC drugs they use and an equally substantial number take a larger dose than recommended or repeat the dose more often than they should, according to a survey by Harris Interactive Inc.
Equally important, the survey found that while the vast majority of Americans (95 percent) read some portion of the label on nonprescription drugs, most only seek partial information. For example, when asked what they look for when buying an OTC product for the first time, only a third (34 percent) of those surveyed say they look for the active ingredient, while 1 in 5 (19 percent) say they seek out the usage directions and 1 in 6 (16 percent) look at the dosage level.
To the rescue come a new Drug Facts label and an education campaign about it, both having promise of success, especially viewed in light of the nutrition label, which served as a model.
Indeed, many of us remember when buying food was one of life's mysteries because ingredient and nutrition content were confusing or missing. Then the congressionally mandated nutrition label went into effect in January 1994. It imparts important information in a standard format. Surveys by government and industry repeatedly show widespread use of food labels, which contributes to good health and facilitates attention to special diets.
The Drug Facts label which contains relatively simple language, readable size type, and clear facts about ingredients, dosage and warnings is required by FDA and has already debuted on many products. Most OTC medicines made after May 16, 2002, must carry it, and certain items have a May 2005 deadline. FDA has been calling the drug label to public attention by means of public service announcements and magazine ads, and is creating a brochure. But the agency cannot do the whole job of teaching not only patients but also health-care professionals what they need to know on the subject.
Enter the National Council on Patient Information and Education, a coalition of industry, consumer and other groups born 20 years ago to focus on better communication about prescription medicines and now covering all medicines. Introduction of the drug label presented a "teachable moment, when the public will be especially receptive to information about how to use [it]," said Ray Bullman, executive vice president of NCPIE.
Based on the findings of the Harris interactive survey, NCPIE created Be MedWise, a national drive that emphasizes three Rs:
Respect for the power and benefits of medicines, including over the counter medicines.
An appreciation of their Risk if used inappropriately.
The need to take Responsibility when using OTC medicines.
Be MedWise is reaching out to health-care professionals as well as consumers through NCPIE's 150 members organizations, national advertising, and an excellent web site www.bemedwise.org. On the Web site, for example, a clear, colorful table shows the four major ingredients of pain relievers (acetaminophen, ibuprofen, aspirin and naproxen sodium) and both the Rx and OTC brands each contains.
For all this upbeat news, there are limits to what labels can do to enhance well being and reduce health risks. Contrary to hopes that nutrition labels would help mitigate a number of health risks, obesity, for example, has ballooned to an epidemic. Moreover, the simplest food and drug labels contain some difficult, technical language. To illustrate, the term Percent Daily Value on the nutrition label is not well understood. With OTC drugs, ingredients have names like chlorpheniramine mealeate and microcrystalline cellulose that tend to intimidate and confuse.
What to do? Promotions to health professionals should emphasize greater use of generic terms acetaminophen instead of Tylenol, for instance so consumers might gain better knowledge of active ingredients having obscure names. In addition, public education efforts should continue for a long time.
NCPIE apparently intends to do that, but will need to raise funds for this purpose. In the end, Mr. Bullman predicted, "This teachable moment can lead to better outcomes for patients fewer drug interactions and adverse drug effects."

Goody L. Solomon is executive editor of Food Nutrition Health News Service in Washington.

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