Provision of Bilingual Dispensing Labels to Non-Native English Speakers: An Exploratory Study.

Patients with limited English proficiency living in the U.K. receive prescribed medication labels in English. These patients are at risk of worse health outcomes compared with the general population. This article describes a service evaluation of the use of bilingual dispensing labels to facilitate patient understanding of medicine administration instructions. Recruited patients answered two questionnaires to assess engagement with and understanding of their medicine labels. The first was completed at the point of dispensing, and the second within six weeks. Questionnaires were either self-completed or via facilitation over the telephone. A total of 151 participants completed the first questionnaire, and 130 completed the follow-up. Key findings highlighted the lack of engagement by participants with English-language labels and their reliance on asking for help from pharmacy staff, friends, or family to understand the information. However, when provided with information in their preferred language, they reported high levels of understanding and sought help less frequently from a third party. This study has shown that this service has improved understanding of labelling information in this target group.

A dual substrate kinetic model for cytochrome P450BM3-F87G catalysis: simultaneous binding of long chain aldehydes and 4-fluorophenol.

OBJECTIVE: To develop a model for binding and catalysis associated with the stimulation of 4-fluorophenol (4-FP) oxidation in the presence of long chain aldehydes by the enzymatic catalyst, cytochrome P450BM3-F87G. RESULTS: A variation of the Michaeli-Menten kinetic model was employed to describe interactions at the active site of the enzyme, along with computer aided modeling approaches. In addition to the hydroquinone product arising from de-fluorination of 4-FP, a second product (p-fluorocatechol) was also observed and, like the hydroquinone, its rate of formation increased in the presence of the aldehyde. When only aldehyde was present with the enzyme, BM3-F87G catalyzed its oxidation to the corresponding carboxylic acid; however, this activity was inhibited when 4-FP was added to the reaction. A 3D computer model of the active site containing both aldehyde and 4-FP was generated, guided by these kinetic observations. Finally, partitioning between the two phenolic products was examined with an emphasis on the conditions directing the initial epoxidation at either the 2,3- or 3,4-positions on the substrate. Temperature, reaction time, substrate concentration, and the structure of the aldehyde had no substantial effect on the overall product ratios, however the NADPH coupling efficiency decreased when unsaturated aldehydes were included, or when the temperature of the reaction was reduced. CONCLUSIONS: The unsaturated aldehyde, trans-2-decenal, stimulates BM3-F87G catalyzed oxidation of 4-fluorophenol through a cooperative active site binding mode that doesn't influence product distributions or coupling efficiencies, while 4-fluorophenol acts as a competitive inhibitor of aldehyde oxidation.