The Internet as a site for medicines in grey zones.
Medicine Across Borders: Exploration of Grey Zones is an edited book published by African Sun Media. It gathers scholars from multiple disciplines ranging from cultural sciences to medicine, from health economics to pharmacy. It is edited by Susanne Lundin, Rui Liu, Elmi Muller, and Anja Smith.
The book is available open access https://play.google.com/store/books/details?id=y0fxEAAAQBAJ
The problem with substandard and falsified (SF) medical products may grow in high-income countries when e-commerce of medicines increases. Unauthorized websites offer medicines of insufficient quality. This underscores the importance of evaluating how the problem with SF medical products can be prevented from escalating. However, little is known about what knowledge and experience professionals working primarily with medicines have about the phenomenon. This study was conducted to explore purposively selected pharmacists’ experience and knowledge about SF medical products. Twelve individual interviews were conducted with purposively selected pharmacists between May 2021 and September 2021. An interview guide was used with specific questions about e-commerce, which focused on exploring pharmacists’ experience and knowledge about SF medical products. The interviews lasted, on average, 49 min and were analyzed using inductive qualitative content analysis. A main theme ‘Pharmacists as guardians of safe medicines’ emerged. This theme consisted of three categories pinpointing ‘risk factors’, ‘protective factors’, and ‘opportunities for improvement’ regarding SF medical products. Findings suggest that pharmacists can play a role in preventing the problem with SF medical products from escalating. Participants emphasized they were in this line of work to help patients and increase patient safety.
By Amelie Persson, Margareta Troien, Susanne Lundin, Patrik Midlöv and Cecilia Lenander
Exploratory Research in Clinical and Social Pharmacy https://doi.org/10.1016/j.rcsop.2024.100421
On 5 December 2023, Amelie Persson gave a speech on substandard and falsified medical products to doctors and chief pharmacists from Region Skåne. The meeting was led by Stefan Nilsson, chairman of Region Skåne’s Pharmaceutical Council (Läkemedelsrådet), which is the expert body that develops and coordinates pharmaceutical issues within Region Skåne. The focus of the meeting was on the importance of being able to identify an authorised online pharmacy to avoid unknowingly buying substandard or falsified medicines. Amelie also presented a short film, titled Läkemedelskvarten. The film aimed to increase knowledge and awareness of substandard and falsified medicines among medical professionals.
Susanne Lundin and Rui Liu attended a roundtable discussion organized by the World Health Organization (WHO) on 5th-7th December 2023 in Utrecht, Netherlands. Researchers from natural sciences, public health, social sciences and cultural sciences were invited by WHO to discuss how to better address substandard and falsified medical products (SFMP) and informal markets. Susanne and Rui shared findings and publications from our previous and ongoing research projects on SFMP with the expert group.
Above is a group photo of all participants the event “WHO Member State Mechanism on Substandard and Falsified Medical Products –Working Group (H) on Informal Markets: Roundtable of Subject Matter Experts”
On 17-18 October 2023, Emma Eleonorasdotter attended the conference Treading the Path to Human Rights: Gender, substance use and policy in welfare states, in Reykjavik, Iceland. The conference was organized by RIKK – Rotín Institute for gender, equality and difference, with the aim to increase knowledge on gender issues in relation to drug use, among policy makers and practitioners.
Emma held a keynote which was based on her forthcoming book Women’s Drug Use in Everyday Life (Palgrave, dec 2023). She also chaired a methods workshop based on the approach “What is the problem represented to be?”.
On 17 October Olof Sundin presented at Digital history research seminar at Stockholm University. His talk was based on his work on the history of information search, juxtaposing contemporary products such as Google and OpenAI’s ChatGPT with the media historical context provided by Umberto Eco’s famous novel “The Name of the Rose.”
He raises the question: What do monasteries and Silicon Valley’s tech giants have in common? For this purpose he investigates the material properties that constitute the information infrastructure for searching and acquiring knowledge, ranging from libraries, bookshelves, and card catalogs to online information systems and today’s tech corporations. Sundin emphasizes how access to information and the mechanisms for controlling it are shaped by society’s dominant knowledge infrastructure and our collective imaginings of this infrastructure and its future. In this context, the increasing politicization of knowledge infrastructures and the dominance of certain sociotechnical imaginaries indicate developments that could potentially have profound implications for our understanding of the value and control of knowledge, as well as its role in the public sphere.
In a news article published by Sydsvenska, Susanne Lundin, Rui Liu, together with colleague Margareta Troein were interviewed to talk about the phenomenon of people googling one’s health problems. Increased health literacy among care seekers is necessary, but on the other hand, all information available on the internet is not reliable. It therefore is important to understand how and why people are willing to trust health information on the Internet.
Olof Sundin co-authored an online publication (on 21st Sept.) at Information Matters, on the subject of infrastructural meaning-making. Information Matters is a digital-only communication forum for information science, sponsored by the Association for Information Science & Technology. In their publication, Olof and colleague argue that not only is it becoming increasingly difficult to distinguish fact from opinion, but also to understand why certain content ends up in our feeds, recommendations or search results in the first place. Yet it’s more important than ever to understand it. This is where infrastructural meaning-making comes into play, and it’s something that the datafied society needs to understand.
On 7 September, the “RAT Community Meeting on the Use of Search Engine Data in Research” took place in Hamburg. The conference was organised by Professor Dirk Lewandowski and the Search Studies research group at the Hamburg University of Applied Sciences. Olof Sundin and Kristofer Söderström presented ongoing research entitled “Greyzone Medicines and Black Hat SEO”, based on data collected with RAT.
Following the first part of a blog at Medical Humanities, Susanne Lundin in another medical humanities blog (published on 8 August, 2023) continues discussing on the role of ethnology in understanding human society. In this blog, the discussion is centered on research methods and research reflexivity.
Ethnologists often apply patchwork methods in data collection. That is, research material is usually gathered from different sources. It can be through conventional qualitative methods such as in-depth interviews and field observations; it can also be more quantitive-oriented methods such as questionnaires and surveys. It can also be through methods beyond verbal exchange such as drawings.
Ethnologists consider people as both the carriers and builders of culture. Hence, researchers’ own lived experiences as heavily influenced by particular cultural and social systems also provide important insights to interpret the collected material. In this way, the above-described ethnological patchwork method requires constant research reflexivity.
While over-reliance on medicines in care provision and self-care has been widely and critically discussed in and beyond academia, less attention has been paid to how care seekers navigate the medical supply side of healthcare as well as the moral choices they face when examining their options. In a Medical Humanities blog (published May 30, 2023), Emma, Rui and Susanne present preliminary findings from sub-study 1 within the project, drawing on interviews they have conducted in the spring 2023.
In a Medical Humanities blog (published on May 23rd, 2023), Susanne Lundin shows how ethnology as a humanistic discipline can contribute to understanding cultural impacts of medical research.
Susanne writes: “For ethnologists, everyday life becomes a keyhole into how cultural norms are activated in people’s lives, allowing us to see what is considered normal and thus obvious and invisible. Ethnology’s insights reveal the unspoken rules that determine daily routines in homes or workplaces; or, in a medical humanities context, how the digital delivery of medical care creates particular behavioural patterns. For instance, today’s patients have become more like customers. Ethnology examines how such phenomena are rooted in complex historical and cultural patterns”.
The blog is the first section of a 2-part series and discusses the questions ethnologists ask to address medical issues. The second section will be focused on how ethnologists address those questions reflexively.
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