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Saturday, October 22, 2011

Information Prescriptions: Just don't say "job done" or "next!"

The information prescription (IP) is not new. It is what should be a routine intervention that benefits from such initiatives as the specific IP project in 2007, which also produced a final report in 2008.

If people today are expected to self-care, there are recognized problems when they self-information prescribe (or is that paternalism at work?). The provenance of information on the web is a key concern.

In the 1980s and 90s the prescriptions and the management of benzodiazepines in community mental health gradually emerged as a problem. Today (for our children and their children) there's an acute problem with the frequency of antibiotic prescribing. Listen to the informative and sobering BBC Radio 4 programme:

As people are directed to validated and creditable information resources we need to consider the bigger picture that a prescription ('plan') of any sort represents.

A response in the form of a drug/treatment or information prescription does (of course) not mean "job done".

Some follow up may be needed (duh!) as to what has been done with said information. When we speak to people we quickly make global assumptions about their understanding, literacy, motivation and the constraints within which they can operate when outside the clinical encounter. General Practitioners usually have the benefit, and in this context - a great benefit, of having known the patient and the family for many years. Other practitioners may not have that informational reservoir upon which to draw. General practice may itself see changes - pressures on the established patient - family doctor relationship.

The quote below is from the information prescription website:
Information prescriptions contain a series of links or signposts to guide people to sources of information about their health and care – for example information about conditions and treatments, care services, benefits advice and support groups.

Information prescriptions let people know where to get advice, where to get support and where to network with others with a similar condition. They include addresses, telephone numbers and website addresses that people may find helpful, and show where they can go to find out more. They help people to access information when they need it and in the ways that they prefer.
Working in nursing homes I know how demanding and challenging information exchange can be. While the above quote lists suggested content, I've had to signpost in person, once, twice, three times before the time was right for a carer to approach a specific agency for a resource.

Whatever your lingo, personalised information prescriptions are really cool - and hot. We need them.

After all isn't a prescription for drugs just another form of information prescription, molecular, biochemical? One that is also destined to become more personalised and yet on a different informational (genetic) level. More than anything else though we need a public, citizenry who can understand the value, potency of the infoscript in their hand. Is there an antidote for advertising?

 Although the informational exchanges in nursing homes and elsewhere are challenging: we keep trying. To do that the prescriptions should not be used as a means to say "Next!".

Crossroads have historically been meeting places. A space of choices (information) and signposts, make the right choice don't hurry.

Quality outcomes take time, but then I would say that ...

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