This online randomized controlled trial will evaluate whether adding a key information section to patient information leaflets leads to more accurate expectations and improves participants' understanding. We will test the impact of including quantitative information on drug benefits in addition to qualitative statements, versus including qualitative statements only. Participants will be randomly assigned to one of three groups: (1) a standard patient leaflet that contains no information on drug benefits, (2) a leaflet featuring a key information section that includes qualitative statements about drug benefits, or (3) a leaflet featuring a key information section that includes quantitative information about drug benefits in addition to qualitative statements.
Currently, European legislation requires that patient information leaflets accompanying all prescription medicines list the adverse effects of the medicine and provide guidance on its safe and appropriate use. In 2025, the European Medicines Agency (EMA) launched a public consultation on a proposal to include a new 'key information section' in the patient leaflets across Europe. A key information section is intended to help users quickly access non-promotional information about both the drug benefits and risks of a drug. This study aims to evaluate the effect of including information about drug benefits, either qualitatively or both qualitatively and quantitatively, on individuals' expectations of a new cancer drug, using the European patient leaflet. In this online randomized controlled trial, a nationally representative sample of adults from the United Kingdom will be randomly assigned to 1 of 3 versions of a patient leaflet: (1) the standard patient information leaflet (control), (2) a leaflet with the EMA's proposed key information section containing qualitative statements, or (3) a leaflet with a key information section providing both qualitative and quantitative data on the drug's benefits and harms. The patient leaflet used in the study was for a cancer drug (tivozanib). The primary outcome is participants' expectations regarding the drug's benefits and harms. Secondary outcomes include participants' understanding of the information, participants perceived magnitude of the drug's benefits and harms, and their satisfaction with the leaflet content.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
TRIPLE
Enrollment
2,101
The standard patient leaflet supplemented with a key information section. This section included qualitative descriptions of the goal of treatment, the main benefits, contraindications, and the most serious side effects. The content was designed to reflect the EMA's proposed format for improving the patient information leaflet.
The standard patient information leaflet for a recently approved cancer drug, tivozanib (Fotivda), obtained electronically from the EMA website. The standard patient information does not contain structured benefit information.
The standard patient leaflet, supplemented with a key information section including quantitative data on the drug's main benefits and side effects, presented in a summary table format. This section provided structured information about the indication and goal of treatment, how the drug was studied (the comparator treatment and number of patients enrolled in the clinical trial that supported the drug's approval), and data on the drug's benefits and side effects.
London School of Economics and Political Science
London, United Kingdom
Expectations
Multiple choice questions assessing expectations about the benefits of tivozanib, a cancer drug approved by the European Medicines Agency. For example, "does Fotivda cure advanced kidney cancer?" Measured on a 4 point-Likert scale: definitely yes; probably yes; probably no; definitely no.. See attached protocol.
Time frame: Assessed during 15-minute survey.
Understanding
Multiple choice questions assessing participants understanding of the information in the patient leaflet (e.g., what is Fotivda used for?) Each question includes several response options, with 1 correct answer per item. See attached protocol.
Time frame: Assessed during 15-minute survey.
Perceived magnitude of benefits and harms
Multiple choice questions assessing participants perceived magnitude of the drug's benefits and harms (e.g., Overall, how large are the benefits of Fotivda?) Likert scales vary depending on the question. See attached protocol.
Time frame: Assessed during 15-minute survey
Satisfaction with information in the patient leaflet
Multiple choice questions assessing participants' satisfaction with information included in the patient leaflet (e.g., ease of finding and understanding information). Likert scales vary depending on the question. See attached protocol.
Time frame: Assessed during 15-minute survey.
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