Pictograms instead of long and complicated drug instructions improve patient care

The Duke-NUS School of Medicine has introduced visual cues or pictograms designed to make medication instructions easier to understand. Duke-NUS researchers, along with their colleagues, have introduced 35 pictograms and are now working with public health care providers and pharmacies to promote the adoption of this technique so that patients, especially the elderly, can take their medications correctly and safely. Given that patients come to a variety of health care facilities for services, these pictograms will also help standardize medication-related labeling across all health care facilities and pharmacies.

Pictograms can be affixed or printed on prescription drug packages and vials to supplement important information such as the drug name and dosage instructions. Pictograms have been tested among groups of patients and found to be easy to understand.

Currently, each bottle or box of prescription medication is dispensed with a label containing instructions for patients. Some patients, especially the elderly and visually impaired, have difficulty understanding them.  In a study of 1,167 elderly people in Singapore in 2020, one in two reported having difficulty understanding medication labels, leading to uncertainty about when and how often to take medication. This, in turn, was associated with medication non-compliance, i.e. skipping taking medication.

In addition, pharmacists sometimes use their own solutions, such as handwriting medication information in a different language or larger size, or drawing diagrams to help patients better understand the instructions on medication labels. Some health care providers also supplement drug labels with their own set of pictograms.

To address these issues and create a standardized set of pictograms, Duke-NUS researchers and their colleagues at SingHealth clinics, prepared and tested a set of 35 pictograms.

The Improving Prescription Drug Labeling for Senior Citizens project developed or evaluated 35 pictograms. The project conducted two studies of the effectiveness of pictograms in communicating medication-related instructions from March 2019 through February 2021 with over 600 participants.

In these studies, pictograms were tested locally among older adults aged 60 years and older. All 35 pictograms were found to be usable without the need for further testing or modification, with more than 66 percent of study participants interpreting them correctly and more than 85 percent rating the pictograms as representing the intended meaning well.

Associate Professor Rahul Malhotra, Associate Director of the Center for Aging Research and Education (CARE), who led the study as principal investigator, said:

“Older patients rely heavily on medication labels as a source of information due to the higher prevalence of chronic diseases and medication use. There is an urgent need to improve existing medication labels to help older adults take medications safely and better adhere to medication regimens. In our research, we worked closely with patients and pharmacists to redesign and test pictograms to make sure their needs were addressed. Using pictograms can help patients who cannot read to better understand prescriptions, and help healthcare professionals and pharmacists to overcome a barrier when explaining prescriptions to patients. The results of this study will help pave the way for a more sustainable and future-ready healthcare system that will allow people to lead healthier lives for longer.”

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Gachon University Gil Hospital Republic of Korea,IncheonLeave a request

Published: 03.10.2024

Updated: 15.10.2024

Medical author, Medical editor:

Stepan Yuk

Medical expert:

PhD. Olexandr Voznyak