Abstract
Objective This study measured preference for newly designed prescription labels in comparison with two existing labels from the perspective of patients, pharmacists and physicians, based on three parameters: content, convenience and cosmetic appearance. Setting Participants were interviewed at pharmacies (patients) and at professional meetings (physicians and pharmacists) regarding their preference for the labels. Method Two new labels (A and B) were designed using Publisher® Software version 2007 based on literature and results from our previous study. New features focusing on content, convenience and cosmetic appearance (3Cs) included a time table for medication administration, indication of medication and warnings, on a redesigned label. These labels were initially tested on a small sample and then revised. A survey instrument was developed to compare currently used labels and modified labels A and B, on the 3Cs. Main outcome measure The preference of three groups of stakeholders (patients, pharmacists and physicians) were measured for newly designed labels in comparison with two existing labels. Results Complete data obtained with 444 patients, 115 pharmacists and 69 physicians indicated that the median age range of participants was between 51 and 64 years. The patient and physician samples consisted of a higher percentage of women. Pharmacists working in chain pharmacies and family practitioners comprised majority of our sample in professional groups. Mean years of experience in pharmacy and physician groups was 18.2 and 26.8 years, respectively. Most patients (94.4%) in the sample had at least high school education. Majority of patients (82.8%) preferred new labels over existing ones and 55.2% preferred label B on all three parameters. Close to two thirds of pharmacists (76.4%) and physicians (75.3%) preferred new labels with 55.3 and 57.9% preferring label B, respectively. Participants cited all the added modifications as reasons for their preference. Conclusion New prescription labels were favored over existing labels by all stakeholders, for content, convenience and cosmetic appearance. The results may help in making labels more user-friendly and addressing problem areas in labels.
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References
Bernard S. The perfect prescription. 2005. Accessed 15 Oct 2010. Available from: http://www.nymag.com/nymetro/health/features/11700/.
Davis TC, Federman AD, Bass PF III, Jackson RH, Middlebrooks M, Parker RM, et al. Improving patient understanding of prescription drug label instructions. J Gen Intern Med. 2009;24:57–62.
Moisan J, Gaudet M, Gregoire JP, Bouchard R. Non-compliance with drug treatment and reading difficulties with regard to prescription labeling among seniors. J Gerontol. 2002;48:44–51.
Wolf MS, Davis TC, Tilson HH, Bass PF III, Parker RM. Misunderstanding of prescription drug warning labels among patients with low literacy. Am J Health Syst Pharm. 2006;63:1048–55.
Davis TC, Wolf MS, Bass PF III, Middlebrooks M, Kennen E, Baker DW, et al. Low literacy impairs comprehension of prescription drug warning labels. JGIM. 2006;21:847–51.
Webb J, Davis TC, Bernadella P, Clayman ML, Parker RM, Adler D, et al. Patient centered approach for improving prescription drug warning labels. Pat Educ Counsel. 2008;72:443–9.
Davis TC, Wolf MS, Bass PF III, Thompson JA, Tilson HH, Neuberger M, et al. Literacy and misunderstanding prescription drug labels. Ann Intern Med. 2006;145:887–94.
Shrank W, Avorn J, Rolon C, Shekelle P. Effect of content and format of prescription drug labels on readability, understanding, and medication use: a systematic review. Ann Pharmacother. 2007;41:783–801.
Wolf MS, Davis TC, Shrank W, Rapp DN, Bass PF III, Connor UM, et al. To err is human: patient misinterpretations of prescription drug label instructions. Patient Educ Couns. 2007;67:293–300.
Schillinger D. Misunderstanding prescription labels: the genie is out of the bottle. Ann Intern Med. 2006;145:926–8.
Wolf MS, Bailey SC. Improving prescription drug labeling. NC Med J. 2007;68:340–2.
Drummond SR, Drummond RS, Dutton GN. Visual acuity and the ability of the visually impaired to read medication instructions. Br J Ophthalmol. 2004;88:1541–2.
Wogalter MS, Vigilante WJ. Effects of label format on knowledge acquisition and perceived readability by younger and older adults. Ergonomics. 2003;46:327–44.
Ho PM, Magid DJ, Shetterly SM, Olson KL, Maddox TM, Peterson PN, et al. Medication nonadherence is associated with a broad range of adverse outcomes in patients with coronary artery disease. Am Heart J. 2008;155:772–9.
Wilson E, Chen AH, Grumbach K, Wang F, Fernandez A. Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med. 2005;20:800–6.
Pippins JR, Alegria M, Haas JS. Association between language proficiency and the quality of primary care among a national sample of insured Latinos. Med Care. 2007;45:1020–5.
Zed PJ, Abu-Laban RB, Balen RM, Loewen PS, Hohl CM, Brubacher JR, et al. Incidence, severity and preventability of medication-related visits to the emergency department: a prospective study. CMAJ. 2008;178:1563–9.
Senate Bill 472 analysis. Accessed 17 Oct 2010. Available from: http://www.info.sen.ca.gov/pub/07-08/bill/sen/sb_0451-0500/sb_472_cfa_20070906_134626_sen_floor.html.
Personal Communication from the Medications and Healthcare Products Regulatory Agency, UK, 4 Nov 2010.
http://www.legislation.govt.nz/regulation/public/1984/0143/latest/DLM95668.html. Accessed 31 Oct 2010.
http://www.ocpinfo.com. Accessed 27 Oct 2010.
Law AV, Zargarzadeh AH. How do patients read`, understand`, interpret and use prescription drug labels? An exploratory study examining patient and pharmacist perspectives. Int J Pharm Pract. 2010;18:282–9.
Standardizing medication labels: confusing patients less, Workshop Summary, 2008. Accessed 20 Oct 2010. Available from: http://www.nap.edu/catalog/12077.html.
California board of pharmacy rules and regulations. 2008. Accessed 18 Oct 2010. Available from: http://www.pharmacy.ca.gov/laws_regs/lawbook.pdf.
SPSS for windows version 15.0. Chicago: SPSS; 2007.
Cooper JM. Cognitive dissonance: fifty years of a classic theory. Thousand Oaks: Sage Publications, Inc., ISBN10: 1412929733; 2007.
Bernardini C, Ambrogi V, Fardella G, Perioli L, Grandolini G. How to improve the readability of the patient package leaflet: a survey on the use of colour, print size and layout. Pharmacol Res. 2001;43:437–44.
Shrank WH, Gleason PP, Canning C, Walters C, Heaton AH, Saira J, et al. Can improved prescription medication labeling influence adherence to chronic medications? An evaluation of the Target pharmacy label. J Gen Intern Med. 2009;5:570–8.
Shrank WH, Patrick A, Gleason PP, Canning C, Walters C, Heaton AH, et al. An evaluation of the relationship between the implementation of a newly designed prescription drug label at target pharmacies and health outcomes. Med Care. 2009;47:1031–5.
Acknowledgments
We would like to thank our students Meeta Goel, Deborah Kheradyar and Nirav Rathod for their contribution to design of and data collection of this research.
Funding
This study was conducted using restricted research funds provided by the institution.
Conflicts of interest
We hereby declare that no conflict of interest exists with any aspect of this study.
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Amir H. Zargarzadeh was an Outcomes Research Fellow at Western University of Health Sciences when this study was conducted.
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Zargarzadeh, A.H., Law, A.V. Design and test of preference for a new prescription medication label. Int J Clin Pharm 33, 252–259 (2011). https://doi.org/10.1007/s11096-011-9488-z
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DOI: https://doi.org/10.1007/s11096-011-9488-z