Rationale for patient package inserts.

The need for patient package inserts (PPIs) is discussed in terms of the "consumers' right-to-know" and "patient health education" themes, as well as the premise that verbal means of communication are often inadequate. Some of the reasons for the frequent failure of verbal messages are reviewed by detailing the five stages through which any communication must be processed in order to be effective. Verbal information may be inadequate because: (1) patients are not exposed to necessary material, (2) they may not pay attention to the information, (3) they may not understand it, (4) the information may not be accepted as valid, and (5) patients may not remember the material. Written communication which must be processed through the same five stages also may be frequently inadequate. Therefore, PPIs must be viewed as reinforcing and augmenting verbal consultation, and both written and verbal forms are necessary. Consumer surveys and demonstration projects have shown that written communications are a desired and effective means for conveying additional prescription drug information to patients. The wide implementation of PPIs is apt to cause many problems for the pharmacists; however, it may also serve as a means to enhance the pharmacist's clinical role.