Limits...
Development of a patient-centered bilingual prescription drug label.

Mohan A, Riley MB, Boyington D, Johnston P, Trochez K, Jennings C, Mashburn J, Kripalani S - J Health Commun (2013)

Bottom Line: In 5 focus groups and interviews that included 57 participants, patients and pharmacists critically reviewed the designs and compared them with traditional medication labels and reformatted labels without illustrations.Patients preferred having pertinent warnings on the main label instead of auxiliary labels.This design may serve as a prototype for improving prescription drug labeling.

View Article: PubMed Central - PubMed

Affiliation: a Department of Medicine , Emory University School of Medicine , Atlanta , Georgia , USA.

ABSTRACT
Research shows that prescription drug labels are often difficult for patients to understand, which contributes to medication errors and nonadherence. In this study, the authors developed and qualitatively evaluated an evidence-based bilingual prescription container label designed to improve understanding. The authors developed several prototypes in English only or in English and Spanish. The labels included an image of the drug, an icon to show its purpose, and plain-language instructions presented in a 4-time-of-day table. In 5 focus groups and interviews that included 57 participants, patients and pharmacists critically reviewed the designs and compared them with traditional medication labels and reformatted labels without illustrations. Patients strongly preferred labels that grouped patient-relevant content, highlighted key information, and included drug indication icons. They also preferred having the 4-time-of-day table and plain-language text instructions as opposed to either one alone. Patients preferred having pertinent warnings on the main label instead of auxiliary labels. Pharmacists and Latino patients valued having Spanish and English instructions on the label, so both parties could understand the content. The final label design adheres to the latest national- and state-level recommendations for label format and incorporates additional improvements on the basis of patient and pharmacist input. This design may serve as a prototype for improving prescription drug labeling.

Show MeSH
Evolution of patient-centered medication label. (A) The initial Spanish-language prototype. A process of iterative, patient-centered design was used to develop further versions such as (B) this version and, ultimately, (C) the label. (Color figure available online.)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3815084&req=5

Figure 1: Evolution of patient-centered medication label. (A) The initial Spanish-language prototype. A process of iterative, patient-centered design was used to develop further versions such as (B) this version and, ultimately, (C) the label. (Color figure available online.)

Mentions: Using current literature, published best practices, and regulations from the Tennessee Board of Pharmacy and those of California (State of California Board of Pharmacy, 2010), New York (New York State Education Department, 2010), and Texas (Texas Administrative Code Rule 291.33), we developed a prototype of an easy-to-read, patient-centered medication label (henceforth called the patient-centered label). These guidelines vary significantly, but in general require that content be organized and displayed in a way that is sensitive to limitations in visual acuity and health literacy. As shown in Figure 1, the patient-centered label grouped information that is most relevant to patients (e.g., drug name, dose, instructions), used 11-point font for all patient-centered material, used plain language (e.g., “Take 1 pill in the morning and 1 pill in the evening,” instead of “Take one twice daily”), and included drug indication. In addition, we showed the dosing instructions in a table that anchors dosing in four times of day—morning, noon, evening, and bedtime. We have previously used this format successfully in several other settings (Kripalani, 2011), and it has been called the Universal Medication Schedule (Institute of Medicine, 2008). Last, we made several additional enhancements such as including a picture of the medication, icon for drug indication, and warnings on the main label rather than on separate stickers. Icons were developed previously through an iterative process of patient-centered design, resulting in depictions for a list of approximately 100 possible drug indications determined by physicians and pharmacists. A version of the prototype was created in English only and another version in Spanish and English.


Development of a patient-centered bilingual prescription drug label.

Mohan A, Riley MB, Boyington D, Johnston P, Trochez K, Jennings C, Mashburn J, Kripalani S - J Health Commun (2013)

Evolution of patient-centered medication label. (A) The initial Spanish-language prototype. A process of iterative, patient-centered design was used to develop further versions such as (B) this version and, ultimately, (C) the label. (Color figure available online.)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3815084&req=5

Figure 1: Evolution of patient-centered medication label. (A) The initial Spanish-language prototype. A process of iterative, patient-centered design was used to develop further versions such as (B) this version and, ultimately, (C) the label. (Color figure available online.)
Mentions: Using current literature, published best practices, and regulations from the Tennessee Board of Pharmacy and those of California (State of California Board of Pharmacy, 2010), New York (New York State Education Department, 2010), and Texas (Texas Administrative Code Rule 291.33), we developed a prototype of an easy-to-read, patient-centered medication label (henceforth called the patient-centered label). These guidelines vary significantly, but in general require that content be organized and displayed in a way that is sensitive to limitations in visual acuity and health literacy. As shown in Figure 1, the patient-centered label grouped information that is most relevant to patients (e.g., drug name, dose, instructions), used 11-point font for all patient-centered material, used plain language (e.g., “Take 1 pill in the morning and 1 pill in the evening,” instead of “Take one twice daily”), and included drug indication. In addition, we showed the dosing instructions in a table that anchors dosing in four times of day—morning, noon, evening, and bedtime. We have previously used this format successfully in several other settings (Kripalani, 2011), and it has been called the Universal Medication Schedule (Institute of Medicine, 2008). Last, we made several additional enhancements such as including a picture of the medication, icon for drug indication, and warnings on the main label rather than on separate stickers. Icons were developed previously through an iterative process of patient-centered design, resulting in depictions for a list of approximately 100 possible drug indications determined by physicians and pharmacists. A version of the prototype was created in English only and another version in Spanish and English.

Bottom Line: In 5 focus groups and interviews that included 57 participants, patients and pharmacists critically reviewed the designs and compared them with traditional medication labels and reformatted labels without illustrations.Patients preferred having pertinent warnings on the main label instead of auxiliary labels.This design may serve as a prototype for improving prescription drug labeling.

View Article: PubMed Central - PubMed

Affiliation: a Department of Medicine , Emory University School of Medicine , Atlanta , Georgia , USA.

ABSTRACT
Research shows that prescription drug labels are often difficult for patients to understand, which contributes to medication errors and nonadherence. In this study, the authors developed and qualitatively evaluated an evidence-based bilingual prescription container label designed to improve understanding. The authors developed several prototypes in English only or in English and Spanish. The labels included an image of the drug, an icon to show its purpose, and plain-language instructions presented in a 4-time-of-day table. In 5 focus groups and interviews that included 57 participants, patients and pharmacists critically reviewed the designs and compared them with traditional medication labels and reformatted labels without illustrations. Patients strongly preferred labels that grouped patient-relevant content, highlighted key information, and included drug indication icons. They also preferred having the 4-time-of-day table and plain-language text instructions as opposed to either one alone. Patients preferred having pertinent warnings on the main label instead of auxiliary labels. Pharmacists and Latino patients valued having Spanish and English instructions on the label, so both parties could understand the content. The final label design adheres to the latest national- and state-level recommendations for label format and incorporates additional improvements on the basis of patient and pharmacist input. This design may serve as a prototype for improving prescription drug labeling.

Show MeSH