The Prescription Maze

Consumers in the United States spent nearly $14 billion on about 1.5 billion prescriptions in 1983. Considering that 35% of these consumers left the doctor's office with no information about the drugs prescribed, the potential for unexpected and sometimes hazardous food-drug interactions is great. Iowa's Food and Nutrition Extension Service responded to this educational need by developing a comprehensive set of program support materials on food-drug interactions.

We wanted to provide Extension agents with resource materials that would be: (1) accessible, (2) suitable for a variety of audiences, and (3) adaptable to a variety of educational settings. The result was a set of program materials consisting of a slide-tape set, lesson plan, quiz, game, table tents, two publications, media releases, and two displays. All the materials, with the exception of the displays, were organized into a notebook that could be conveniently located.

Although all people who take medications are a potential audience, specific target audiences for the program include the elderly and those with poor diets, chronic health problems, or poor health habits.

While the materials often use specific examples of interactions between foods and prescription or over-the-counter drugs, the main message is for the public to follow six precautions to protect themselves from food-drug interactions: (1) ask questions, (2) follow directions, (3) talk with the doctor, (4) take drugs with water, (5) avoid alcohol with drugs, and (6) eat a balanced diet.

Because of the wide variety of materials provided, education about food-drug interactions can occur in diverse settings. For example, the slide set can be the basis for a 10-minute presentation. If it's not convenient to use a slide projector, the lesson plan is an easy-to-use alternative. In addition, the pre/ post quiz and game add variety to longer presentations and reinforce key ideas. The table tents can be used to build awareness with important target audiences when speaking time is unavailable, such as congregate meal sites, WIC centers, service group luncheons, restaurants, and others. The displays are particularly effective in malls, health fairs, libraries, and even empty store front windows-a common situation in many small towns. Radio, newspapers, and television provide yet another way to increase awareness with general audiences.

One of the main results of these programs is additional questions from clientele. "Facts About Food-Drug Interactions" is a six-page bulletin providing information on why and how interactions occur, as well as detailed information on precautions. Several agents have also recruited local pharmacists to answer more specific questions.

The response from Extension agents about these materials has been enthusiastic. Seventy staff members were trained in the use of the materials in October, 1985. Of the 100 counties in Iowa, staff in 60 counties reported they'd be using the materials within 6 months after training. In fact, within one week of the training, three agents had already presented programs, indicating that our goal of providing a set of easy-to-use materials for this difficult topic had been achieved.

To evaluate the program, agents are now collecting data from the pre/post quiz and a follow-up telephone survey to determine knowledge and practice change. We hope to find these educational efforts have resulted in a greater awareness of the potential for food-drug interactions and a desire by clientele for more information from their doctors and pharmacists.