Résumé
Objectif
Les dernières données pancanadiennes sur l’hypertension révélaient que seulement 33 % des hypertendus prenaient des médicaments et moins de la moitié d’entre eux contrôlaient leur pression artérielle. Une des causes importantes de cette difficulté à contrôler la pression artérielle est l’inobservance médicamenteuse. Par ailleurs, la couverture médiatique des faits de santé a un impact sur les croyances, les attitudes et les comportements de santé. Notre objectif est d’analyser les contenus des journaux sur les médicaments en lien avec l’hypertension.
Méthode
Nous avons effectué une analyse thématique du contenu des journaux traitant des médicaments en lien avec l’hypertension. Notre corpus comprend 104 articles tirés de 3 des plus importants journaux canadiens francophones: un journal de référence, un omnibus grand format et un tabloïde.
Résultats
Nous avons identifié 3 thèmes principaux: 1) les médicaments comme traitement efficace, 2) les cas problématiques particuliers et 3) les problèmes de l’approche pharmacologique en général. On note une gradation du positif au négatif au fur et à mesure qu’on passe du journal plus sérieux au plus populaire. Nous discutons la thèse de Fiske selon laquelle les tabloïdes sont le lieu d’une opposition populaire au discours des groupes détenteurs de pouvoir.
Conclusion
Dans le tabloïde, le journal le plus lu au Québec, le médicament est souvent présenté négativement dans les contenus sur l’hypertension. Cependant, d’autres études sont nécessaires afin de déterminer s’il existe un lien causal entre les discours médiatiques et le phénomène de l’inobservance médicamenteuse.
Mots clés: hypertension, médicaments, inobservance, médias, journaux
Abstract
Objective
The most recent country-wide Canadian data have revealed that only 33% of people with hypertension take medication and fewer than half of them have their blood pressure under control. One of the most important reasons for difficulty in controlling blood pressure is lack of drug treatment compliance. In addition, media coverage of health facts has an impact on beliefs, attitudes and behaviours related to health. Our goal was to analyze newspaper coverage of drugs related to hypertension.
Method
We conducted a thematic content analysis of newspapers covering medications related to hypertension. The study comprised 104 articles drawn from three of the most important francophone daily newspapers in Canada - a reference one, a general broadsheet and a tabloid.
Results
We identified three major themes:1) drugs as an effective treatment, 2) specific problematic cases, and 3) problems with the pharmacological approach in general. We noted a gradual change from positive to negative as we moved from the most serious newspaper to the most popular. We discuss the Fiske hypothesis which suggests that tabloid-format newspapers are a repository of popular opposition to the discourse of groups who hold power in society.
Conclusion
In the tabloid, the most widely-read newspaper in Québec, medications are often presented in negative fashion in articles on hypertension. However, further studies are required to determine if there is a causal association between media discourse and the phenomenon of lack of drug treatment compliance.
Key words: Hypertension, medications, prescription drugs, compliance, media, newspapers
Footnotes
Remerciement: Cette étude a été réalisée grâce à une subvention des Instituts de Recherche en Santé du Canada (IRSC/CIHR). Les auteurs remercient Daphnée Poirier pour sa contribution à cette étude.
Conflit d’intérêts: Aucun à déclarer.
Références
- 1.World Health Organization. The World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva, Switzerland: WHO; 2002. [Google Scholar]
- 2.Garcia EA, Newhouse S, Caufield MJ, Munroe PB. Genes and hypertension. Curr Pharm Design. 2003;9(21):1679–89. doi: 10.2174/1381612033454513. [DOI] [PubMed] [Google Scholar]
- 3.Padwal R, Campbell N, Touyz RM. Applying the 2005 Canadian Hypertension Education Program recommendations: Lifestyle modifications to prevent and treat hypertension. CMAJ. 2005;173(7):749–51. doi: 10.1503/cmaj.050186. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Tomson J, Lip GYH. Blood pressure demographics: Nature or nurture…genes or environment. BMC Med. 2005;3:3. doi: 10.1186/1741-7015-3-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Joffres MR, Hamet P, MacLean DR, L’Italien GJ, Fodor G. Distribution of blood pressure and hypertension in Canada and the United States. Am J Hypertens. 2001;14(11):1099–105. doi: 10.1016/S0895-7061(01)02211-7. [DOI] [PubMed] [Google Scholar]
- 6.Nuesch R, Schroeder K, Dieterle T, Martina B, Battegay E. Relation between insufficient response to antihypertensive treatment and poor compliance with treatment: A prospective case-control study. BMJ. 2001;323(7305):142–46. doi: 10.1136/bmj.323.7305.142. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Caro JJ, Salas M, Speckman JL, Raggio G, Jackson JD. Persistence with treatment for hypertension in actual practice. CMAJ. 1999;160(1):31–37. [PMC free article] [PubMed] [Google Scholar]
- 8.Perreault S, Lamarre D, Blais L, Dragomir A, Berbiche D, Lalonde L, et al. Persistence with treatment in newly treated middle-aged patients with essential hypertension. Ann Pharmacother. 2005;39(9):1401–8. doi: 10.1345/aph.1E548. [DOI] [PubMed] [Google Scholar]
- 9.Nair K, Dolovich L, Cassels A, McCormack J, Levine M, Gray J, et al. What patients want to know about their medications. Can Fam Phys. 2002;48(1):104–10. [PMC free article] [PubMed] [Google Scholar]
- 10.Dutta-Bergman MJ. Primary sources of health information: Comparisons in the domain of health attitudes, health cognitions, and health behaviors. Health Commun. 2004;16(3):273–88. doi: 10.1207/S15327027HC1603_1. [DOI] [PubMed] [Google Scholar]
- 11.Wigand RT. Health information dissemination in the information age: Media, message and roles. Communication. 1994;19(2–3):209–22. [Google Scholar]
- 12.Entwistle V. Reporting research in medical journals and newspapers. BMJ. 1995;310(6984):920–23. doi: 10.1136/bmj.310.6984.920. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Gasher M, Hayes M, Ross I, Hackett R, Gutstein D, Dunn J. Spreading the news: Social determinants of health reportage in Canadian daily newspapers. Can J Commun. 2007;32(3-4):557–74. [Google Scholar]
- 14.Lexchin J, Bero LA, Djulbegovic B, Clark O. Pharmaceutical industry sponsorship and research outcome and quality: Systematic review. BMJ. 2003;326(7400):1167–70. doi: 10.1136/bmj.326.7400.1167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Wazana A. Physicians and the pharmaceutical industry: Is a gift ever just a gift? JAMA. 2000;283(3):373–80. doi: 10.1001/jama.283.3.373. [DOI] [PubMed] [Google Scholar]
- 16.Cassels A, Hughes MA, Cole C, Mintzes B, Lexchin J, McCormack J. Canadian Centre for Policy Alternatives. 2003. Drugs in the news: How well do Canadian newspapers report the good, the bad and the ugly of new prescription drugs? [Google Scholar]
- 17.Fowler R. Language in the News: Discourse and Ideology in the Press. Londres, R-U: Routledge; 1991. [Google Scholar]
- 18.Clarke JN, Binns J. The portrayal of heart disease in mass print magazines, 1991–2001. Health Commun. 2006;19(1):39–48. doi: 10.1207/s15327027hc1901_5. [DOI] [PubMed] [Google Scholar]
- 19.Cassels A, Hughes MA, Cole C, Mintzes B, Lexchin J, McCormack JP. Drugs in the news: An analysis of Canadian newspaper coverage of new prescription drugs. CMAJ. 2003;168(9):1133–37. [PMC free article] [PubMed] [Google Scholar]
- 20.Macdonald MM, Hoffman-Goetz L. A retrospective study of the accuracy of cancer information in Ontario daily newspapers. Can J Public Health. 2002;93(2):142–45. doi: 10.1007/BF03404556. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Moynihan R, Bero L, Ross-Degnan D, Henry D, Lee K, Watkins J, et al. Coverage by the news media of the benefits and risks of medications. N Engl J Med. 2000;342(22):1645–50. doi: 10.1056/NEJM200006013422206. [DOI] [PubMed] [Google Scholar]
- 22.Fiske J. Popularity and the politics of information. In: Dahlgren P, Sparks C, editors. Journalism and Popular Culture. Londres: Sage Publications; 1992. [Google Scholar]
- 23.Hayashi K. The ‘Home and Family’ section in the Japanese newspaper. In: Sparks C, Tulloch J, editors. Tabloid Tales. New York, Oxford: Rowman & Littlefield; 2000. [Google Scholar]
- 24.Corbeil J, Blaser C. Ottawa, Statistics Canada. 2007. The Evolving Linguistic Portrait, 2006 Census. [Google Scholar]
- 25.Paillé P, Mucchielli A. L’analyse qualitative en sciences humaines et sociales. Paris: Armand Colin; 2003. [Google Scholar]
- 26.Seale C. Media and Health. Londres: Sage Publications; 2002. [Google Scholar]
- 27.Lupton D. The Imperative of Health: Public Health and Regulated Body. Londres, Thousand Oaks: Sage; 1995. [Google Scholar]
- 28.Wallack L. Mass media and health promotion: Promise, problem, and challenge. In: Atkin C, Wallack L, editors. Mass Communication and Public Health: Complexities and Conflicts. Newbury Park, CA: Sage; 1990. [Google Scholar]
- 29.Atkin C, Arkin E. Issues and initiatives in communicating health information to the public. In: Atkin C, Wallack L, editors. Mass Communication and Public Health: Complexities and Conflicts. Newbury Park: Sage; 1990. [Google Scholar]
- 30.Proulx M. Des rationalités profanes à la compréhension du mésusage des médicaments antihypertenseurs. In: Collin J, Ottero M, Monnais L, editors. Le médicament au cœur de la socialité contemporaine. Sainte-Foy, QC: Presse de l’Université du Québec; 2006. [Google Scholar]