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Table 2 Examples of non-compliance per key criteria from the disease awareness campaigns

From: Disease awareness campaigns in printed and online media in Latvia: cross-sectional study on consistency with WHO ethical criteria for medicinal drug promotion and European standards

Key criteria Problem identified Example (condition)
Promotional information Reference to pharmaceutical products to treat a condition or disease in combination with:
- the name, logo and website of a pharmaceutical company;
- or a website for a disease awareness campaign;
- or quick response codes to dedicated websites.
“For example, one of the current treatments recommended by doctors for premature ejaculation is a serotonin reuptake inhibitor which prolongs intercourse for men older than 18 for up to 200–400%”. The name and logo of a pharmaceutical company as well as a dedicated website are mentioned. (Premature ejaculation) [32]
“My doctor informed me about a compassionate use program in which 17 patients with hepatitis C had an opportunity to receive the new non-interferon therapy for free, which guaranteed 97–100% cure rate. […] The program was supported by pharmaceutical company X”. (Hepatitis C) [21]
A website about upper respiratory tract conditions states: “inhaled corticosteroids are the most effective bronchial asthma therapy”. The website includes the logo and the name of an asthma medication manufacturer (Asthma, website, LV).
“Selective progesterone receptor modulator is the approved pharmaceutical treatment for uterine fibroids. It reduces bleeding and fibroid volume.” The website includes the logo of a pharmaceutical company, as well as a section for specialists where the product’s brandname is mentioned (Uterine fibroid, website, LV)
Misleading or incomplete information No reference is provided to the sources of information provided about prevalence of disease. “Approximately 90% of the world population suffers from lower back, neck line and muscle pain…” (Back pain, RU)
“Every 30 s someone has a fracture due to osteoporosis”. (Osteoporosis, RU)
“After reaching 60 years of age, approximately 60% of population suffers from venous insufficiency” (Varicose veins, LV)
“It is possible that you are among the 90% of the population who suffer from herpes blisters. Here is the information that you need to know about the herpes virus.” (Herpes, LV)
“Approximately half of ovarian cancer cases are lethal. This is due to the asymptomatic nature of the cancer and delayed diagnosis” (Cancer, LV)
Use of fear Reference to disability caused by the disease, either through text or picture. “If left untreated hemorrhoids will only get worse – inflamation will develop into abcess, pain will increase, bleeding and prolapse will form thrombs.” (Hemorrhoids, RU)
“If Lyme disease is not diagnosed and treated in a timely manner, other symptoms of Lyme disease can develop several weeks, months or years after the tick bite, such as arthritis, nervous system or cardiovascular disorders” (Lyme disease, LV)
Inadequate language Uses medical terminology “[High blood pressure] also increases the risk of heart diseases - ischemic heart disease, cardiomyopathy, development of infarction and stroke.” (Cardiovascular disease, LV)
Lack of balance More emphasis on the benefits of pharmaceutical treatment than risks. Symptoms are accentuated by layout and/or enumeration. Risk factors are portrayed as diseases. Treatment is accentuated. “Botulin injections are one of the most effective methods to fight excessive sweating. […] The effect will appear on the 4th to 6th day after the injection and will last six to 9 months. ”(Excessive sweating, LV).
Symptoms are referred to in headings in big and bold typeface. (Diabetes, Nr 105, LV) (Asthma, Nr 30) (Alzheimer, Nr 138, LV)
“There are several tablets you can use for the treatment of erectile dysfunction. […] There is a high chance that treatment will work (in 8 cases out of 10 treatment is effective). Please discuss the advantages and disadvantages of these treatments with your doctor.” (Erectile dysfunction website, LV)
Use of testimonials Specialist mentions treatment and specific drug classes Quote from a general practitioner “If you have frequent and pronounced herpes infections you will need to use acyclovir [tablets] – a serious medication in high doses.” (Herpes simplex infection, Nr. 9, LV)
A comparison is made of the patient’s experience before and after treatment with a specific drug. “I trust my doctor a lot but I was still worried that [with a new therapy] I would experience the same side effects I had before... This time everything was different! I only had to worry about taking my pills on time.” (Hepatitis C, Nr 52, LV)
Absence of author and/or sponsor No author and/or sponsor identified. Conditions or Symptoms where this non compliance was identified:
Anemia
Alzheimer
Diabetes,
Cancer (breast, cervical, colorectal, melanoma)
Cough
Contraception
Glaucoma
Gout
Excessive sweating
Eye infection
Eating disorders
Female sexual dysfunction
fibromioma
Heart failure
Heart attack
Hemorrhoids
Hepatitis C
Herpes simplex
Hypertension
Lyme disease
Migraine
Nail fungus
Osteoporosis
Pain
Parkinson
Psoriasis
Pulmonary arterial hypertension
Seasonal affective disorder
Smoking cessation
Sport related injuries
Stroke
Seasonal allergy
Trophic ulcers
Varicose veins
Warts
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