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Ferreira-Alfaya FJ. Comprehension of pharmaceutical pictograms in sub-Saharan migrants newly arriving in Europe: An exploratory study. J Am Pharm Assoc (2003) 2024; 64:535-539.e3. [PMID: 38158019 DOI: 10.1016/j.japh.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/02/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Migratory pressure from sub-Saharan Africa on Europe must also be addressed from a health literacy perspective. Sub-Saharan migrants newly arriving in Europe generally have lower literacy skills compared to the host community's citizens and special learning needs. Pictograms give health professionals a means of communicating medication instructions to people with no common language or who are illiterate, or both. OBJECTIVE This work aimed to explore the comprehension of a set of United States Pharmacopoeia (USP) pictograms by sub-Saharan migrants newly arriving in Europe. METHODS A quantitative cross-sectional study was carried out. A voluntary survey was conducted among a population ≥ 18 years of age in a Temporary Stay Centre for Immigrants located in the Spanish city of Melilla (North Africa) in June 2022. The form included a selection of 10 USP pictograms to assess their comprehension. According to the International Organization for Standardization, a pictogram must receive 66.70% correct answers to be acceptable. RESULTS Fifty-one sub-Saharan immigrants participated in this study. None of the pictograms reached comprehensibility threshold. CONCLUSION Pharmaceutical pictograms are ineffective in practice when they are not designed in a culturally sensitive manner.
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Ferreira-Alfaya FJ, Zarzuelo-Romero MJ, Cura Y. Pharmaceutical pictograms to improve textual comprehension: A systematic review. Res Social Adm Pharm 2024; 20:75-85. [PMID: 38030546 DOI: 10.1016/j.sapharm.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 11/19/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Written instructive information for the patient is key in pharmaceutical care. However, the preexisting literature agrees on the discordance between the readability of written medication messages intended for patients. The aim of our work was to systematically review the available evidence on the effect of pharmaceutical pictograms as elements that facilitate understanding of the text in primary or secondary medication packaging. METHODS A parallel systematic search was conducted of the literature covering evidence of the effect of including pictograms in primary or secondary packaging on comprehension by potential users or caregivers up to April 9, 2023. The databases consulted were Scopus, MEDLINE and Web of Science. Only randomized controlled studies, whose main outcome measure was comprehension, were included. RESULTS Only 8 papers met our search criteria. In most of the included studies, the intervention of including pictograms improved participants' performance in comprehending instructions. A debatable methodological quality, and differences in the target population, textual complexity of the materials or the cultural affinity of the pictograms with the target population in each study, could have had a decisive influence on the results. CONCLUSION The heterogeneity in the design of each study poses a significant barrier to establishing commonalities and generalizing the results. This heterogeneity also prevented us from conclusively confirming the usefulness of pictograms complementary to instructional text in improving the comprehension of instructions for the rational use of medicines.
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Affiliation(s)
| | | | - Yasmin Cura
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Granada, Spain
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Dowse R, Okeyo S, Sikhondze S, Khumalo N. Pharmaceutical indication pictograms for low literacy viewers: Health literacy and comprehension. Health SA 2023; 28:2192. [PMID: 37927939 PMCID: PMC10623492 DOI: 10.4102/hsag.v28i0.2192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 07/19/2023] [Indexed: 11/07/2023] Open
Abstract
Background Poor comprehension of pharmaceutical pictograms used on medicine labels or leaflets can compromise understanding of medicine-taking information, potentially causing negative health outcomes. Aim The aim was to assess association of health literacy (HL) with comprehension of pictograms displaying indication and side effect information in a lower literacy, limited English proficiency (LEP) population. Setting Community centre, Makhanda, South Africa. Methods This was a quantitative cross-sectional study using simple random probability sampling. Ninety isiXhosa-speaking adults with a maximum of 12 years schooling, attending primary healthcare clinics were interviewed using structured interviews. Health literacy was assessed using the Health Literacy Test for Limited Literacy populations. Comprehension of 10 locally developed pictograms was evaluated. Results The mean pictogram comprehension score was 7.9/10, with 8/10 pictograms complying with the International Organization for Standardization criterion of 66.7% correct comprehension. Only 15.6% of participants had adequate HL. A significant association of HL with pictogram comprehension was established (p = 0.002). Pictogram misinterpretation was higher in those with lower HL; adequate HL was associated with superior comprehension. Pictogram comprehension was negatively associated with age (p < 0.006), and positively associated with education (p < 0.001) and English proficiency (p < 0.001). Conclusion Higher HL was associated with better pictogram comprehension. Low HL, LEP and low education levels are regarded as potential indicators for possible pictogram misinterpretation. Contribution This study observed the potential for misinterpretation of medication pictograms. Health professionals should be aware that low HL, limited schooling and limited English proficiency could signal difficulty in fully comprehending pictogram content.
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Affiliation(s)
- Ros Dowse
- Department of Pharmacy, Faculty of Pharmacy, Rhodes University, Makhanda, South Africa
| | - Sam Okeyo
- Department of Pharmacy, Faculty of Pharmacy, Rhodes University, Makhanda, South Africa
| | - Simise Sikhondze
- Department of Pharmacy, Faculty of Pharmacy, Rhodes University, Makhanda, South Africa
| | - Nosihle Khumalo
- Department of Pharmacy, Faculty of Pharmacy, Rhodes University, Makhanda, South Africa
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Negash Z, Yibeltal Y, Ayele AG. HIV/AIDS patients' knowledge, attitude, and practice toward anti-retroviral therapy medications' adverse effects and associated factors in Tikur Anbessa Specialized Hospital. Ther Adv Drug Saf 2023; 14:20420986231194752. [PMID: 37667777 PMCID: PMC10475229 DOI: 10.1177/20420986231194752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/28/2023] [Indexed: 09/06/2023] Open
Abstract
Background Adverse effects (AEs) have been reported with all antiretroviral therapy (ART) medications, and it was among the most common cause for switching or terminating therapy and drug non-adherence. Even though AEs of ART medications are common and to be expected, little study has been conducted on the understanding of patients on the AEs. Therefore, this study aimed to assess patients' knowledge, attitude, and practice (KAP) toward ART medications' AEs and associated factors. Methods A cross-sectional study design was applied using an interviewer-administered questionnaire from June to September 2021 on human immunodeficiency virus/acquired immunodeficiency syndrome patients on follow-up at Tikur Anbessa Specialized Hospital, Ethiopia. Data was gathered, cleaned, and analyzed using SPSS version 23. Logistic regression analysis was performed to assess the relationship between the independent variable and patients' knowledge and attitude about the AEs of ART medication. A p-value of 0.05 was used to determine the statistical significance. Results About 230 people were enrolled in this study, with 51.3% of them female. Study participants had a mean age of 36 years (standard deviation = 14.19). Of 230 participants, 67.8% had received advice on the AEs of ART medications. Poor knowledge and attitude were observed among 47.8 and 51.3% of respondents, respectively. Prior AEs experience, lack of experiencing opportunistic infection, and lack of counseling about ART medications' AEs were associated with poor knowledge, whereas female gender and a lack of counseling regarding ART medications' AEs were associated with a negative attitude (p < 0.05). Even though most patients (81.7%) report AEs of the medication to professionals, a significant number of patients involved in malpractices such as taking other drugs to treat AEs (24.3%), not prepared to do anything (27.1%), change the suspected drug (24.3%), reduce the dose (18.7%), and use local herbal medicines to treat suspected AEs (20.2%). Conclusion Overall, the study participants had poor knowledge, lack of positive attitudes, and non-adherence to the actual recommended practice toward AEs of ART medications. Lack of comorbidity, having prior AEs experience, and lack of counseling regarding ART medication AEs were associated with poor knowledge. Female gender and a lack of counseling on the AEs of ART medications were associated with a negative attitude.
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Affiliation(s)
- Zenebe Negash
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Yohannes Yibeltal
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Akeberegn Gorems Ayele
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Dowse R, Okeyo S, Sikhondze S, Khumalo N. Methodology of an approach for modifying pictograms showing medication side effects or indication. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:147-157. [PMID: 37401879 DOI: 10.1080/17538068.2022.2056292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
BACKGROUND Pictograms may improve user-friendliness and comprehension of written or verbal health information. This paper describes a method to modify pictograms to improve their visual clarity, appeal and overall interpretive complexity in order to reduce the cognitive load on the viewer during comprehension. METHODOLOGY Nine pictograms previously tested for comprehension were selected for modification. In phase 1, two participatory design workshops were conducted with (a) three limited literacy, first-language isiXhosa-speaking participants and (b) four university students. Opinions and ideas for improving interpretation were discussed. In phase 2, revised visuals were generated by the graphic artist and subsequently modified in an intensive, multistage, iterative process. RESULTS As no guidelines for pictogram modification exist, a modification schema was developed based on the process described in this study. Adopting a participatory approach combined with a systematic, intensive modification process enabled the opinions and preferences of the end-users to be heard, ensuring cultural relevance and contextual familiarity of the final product. Careful scrutiny of all individual visual elements of each pictogram, considerations of space, and thickness of lines all contributed to improving the legibility of visuals. CONCLUSIONS The methodology for designing and modifying existing pictograms using a participatory process resulted in nine final pictograms that were approved by all design team members and considered good candidates for subsequent comprehension testing. The methodological schema presented in this paper provides guidance to researchers intending to design or modify pictograms.
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Affiliation(s)
- Ros Dowse
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Sam Okeyo
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Simise Sikhondze
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Nosihle Khumalo
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
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Nkomo N. Governing Oneself Through HIV Diagnosis to Antiretrovirals. QUALITATIVE HEALTH RESEARCH 2023; 33:440-450. [PMID: 36883001 PMCID: PMC10126437 DOI: 10.1177/10497323231159804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The article focuses on the experience of reinventing oneself post HIV diagnosis when living on antiretrovirals. Six women and men enlisted for antiretrovirals in South African public health facilities were interviewed, and a qualitative analysis was conducted drawing on Foucault's theory of governmentality. For the participants, the prevailing governing rationality of taking personal responsibility for their health is synonymous with self-recovery and restoration of self-determination. From the hopelessness and despair of HIV diagnosis, for all six participants, committing to antiretrovirals enhances their capacity to take back control of their transformation from victim to survivor, and with it, a sense of personal integrity. Yet, an unwavering resolve to use ARVs is not always possible for some of them, is not preferable or is not always desirable, which perhaps signals that for certain people living with HIV, their life-long journey of self-governance with ARVs is likely to be characterized by constant contradictions.
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Affiliation(s)
- Nkululeko Nkomo
- Department of Psychology, School of Human
and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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Enslin D, Mallya P. Factors influencing treatment adherence in hypertension and HIV management in South Africa: A comparative literature review. S Afr Fam Pract (2004) 2022; 64:e1-e10. [PMID: 36073101 PMCID: PMC10064525 DOI: 10.4102/safp.v64i1.5434] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 03/29/2022] [Accepted: 04/11/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Hypertension (HTN) is the most significant risk factor for cardiovascular disease (CVD) in South Africa (SA), with one in three people over the age of 25 suffering from HTN. Whilst human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) are the leading causes of death in South Africa, CVD is in the top 10 causes of death, demonstrating the importance of detecting and controlling blood pressure early on. This study aimed to review adherence factors to antihypertensive medication and antiretroviral therapy (ART) and evaluate the resulting factors influencing adherence discrepancies within the South African population. METHODS A comprehensive literature review was carried out. PubMed, ScienceDirect, Cochrane and Embase were searched for English publications between 2000 and 2021. RESULTS A total of 50 articles covering quantitative and qualitative studies were included. Many studies identified poor adherence levels to antihypertensive treatment, reaching a substandard adherence rate of 41.9%, whilst most studies on the HIV-positive population reported good levels of adherence, with adherence rates of more than 90%. Being of the male gender, advanced age, low socioeconomic status and a low level of education were associated with unsatisfactory adherence rates in both groups. Within the HIV group, more participants had better knowledge concerning the extent of their disease and its required treatments. CONCLUSION The results present substandard adherence levels to antihypertensives compared with antiretroviral (ARV) adherence, despite the influence of more non-adherence factors in the HIV group. The authors recommend better adherence counselling for patients with HTN during every clinic visit, regular healthcare worker training and the implementation of ART adherence programmes in patients with hypertension.
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Affiliation(s)
- Dimitra Enslin
- Department of Health Sciences, Faculty of Life Sciences and Education, University of South Wales, Pontypridd.
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The Effectiveness and Value of Written Medicine Information Across Asia and Africa: Systematic Review. Drug Saf 2021; 44:1283-1295. [PMID: 34623626 DOI: 10.1007/s40264-021-01114-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Abstract
Reviews on the role, value, effectiveness and desirable content of written medicine information (WMI) mostly include studies from high-income countries. We reviewed studies from Africa and Asia published between January 2004 and December 2019 to determine (1) the effect of WMI on knowledge and behaviour and (2) whether patients value WMI and their preferences for WMI. We included 16 intervention studies involving almost 3500 participants and 27 surveys of patients/public totalling over 11,000 people. Both the quality of the intervention studies and the reporting quality varied. Surveys were mostly localised, many with inadequate sampling strategies, and hence, were poorly representative of wider populations. However, most included a high proportion of participants with low educational levels. Most of the intervention studies reported significant improvements in knowledge and/or adherence after provision of WMI. Many utilised specially developed WMI in local languages, enhanced by pictograms. Provision of verbal information in addition to WMI showed variable impact. The proportion of people who read WMI, used as an indicator of its value, was reported in 15 surveys, with an overall figure of 74%. The most desirable aspects of WMI reported in 12 studies were indication, side effects, dose/instructions for use, contraindications, precautions and interactions. Nine studies reported local language was desirable. The studies suggest that WMI can improve both knowledge and adherence and is highly valued by people in many countries across Africa and Asia. Mechanisms should be considered by regulatory authorities and manufacturers to facilitate the provision of leaflets in local languages using simple terminology, perhaps enhanced by pictograms.This study is registered with PROSPERO, registration number: CRD42019127001.
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Merks P, Cameron J, Bilmin K, Świeczkowski D, Chmielewska-Ignatowicz T, Harężlak T, Białoszewska K, Sola KF, Jaguszewski MJ, Vaillancourt R. Medication Adherence and the Role of Pictograms in Medication Counselling of Chronic Patients: a Review. Front Pharmacol 2021; 12:582200. [PMID: 34489688 PMCID: PMC8417421 DOI: 10.3389/fphar.2021.582200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/19/2021] [Indexed: 11/25/2022] Open
Abstract
Pharmaceutical care requires a patient-centered approach, focusing on the ability of patients to understand drug-related information and follow the instructions delivered by pharmacists as well as other health-care providers included in the circle of care. With the goal of ensuring the prescribed use of medications, called medication adherence, health-care providers have to consider many risk factors such as geography (culture), social economic status, age, and low literacy that may predispose patients to non-adherence, and considerations have to be made for chronic patients living with life-long disease states. The aim of this review is to provide a balanced and comprehensive review outlining a number of different medication counselling and education approaches that have been used to try to improve medication adherence and health outcomes with the use of clear and concise graphic illustrations—called pictograms. By highlighting the current landscape of the general use and efficacy of pharmaceutical pictograms to aid in the knowledge and recall of drug-related information, as well as outlining specific medication adherence outcomes with pharmaceutical pictograms in chronic patients, the current review describes the need for health-care providers to move beyond the traditional didactic methods of oral and verbal communication with patients regarding medication-taking behavior.
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Affiliation(s)
- Piotr Merks
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland.,Department of Pharmaceutical Technology, Collegium Medicum, Nicolaus Copernicus University, Toruń, Poland
| | - Jameason Cameron
- Department of Pharmacy, Children's Hospital of Eastern Ontario, Centre Hospitalier pour Enfants de L'est de L'Ontario, Ottawa, ON, Canada
| | - Krzysztof Bilmin
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland
| | - Damian Świeczkowski
- First Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | | | - Tomasz Harężlak
- Department of Pharmaceutical Technology, Collegium Medicum, Nicolaus Copernicus University, Toruń, Poland
| | | | | | | | - Regis Vaillancourt
- Department of Pharmacy, Children's Hospital of Eastern Ontario, Centre Hospitalier pour Enfants de L'est de L'Ontario, Ottawa, ON, Canada
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Bärnighausen K, Geldsetzer P, Matse S, Hettema A, Hughey AB, Dlamini P, Mavuso M, Fakudze D, Kahn K, Bärnighausen T, McMahon SA. Qualitative accounts of PrEP discontinuation from the general population in Eswatini. CULTURE, HEALTH & SEXUALITY 2021; 23:1198-1214. [PMID: 32633617 DOI: 10.1080/13691058.2020.1770333] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 05/13/2020] [Indexed: 06/11/2023]
Abstract
People in receipt of pre-exposure prophylaxis (PrEP) for the prevention of HIV in Sub-Saharan Africa often discontinue taking the medication. We conducted 27 semi-structured interviews with men and women who had started PrEP but did not return to the clinic for a refill after a 1, 2 or 3-month period. These 'discontinuation' clients were enrolled in a PrEP demonstration project for the general population in nurse-led, public-sector, primary-care clinics in Eswatini. Reasons for discontinuation included changes to self-perceived HIV risk such as the end of pregnancy and absent partners. Others described PrEP as inaccessible when working away from home and many described difficulties relating to a daily pill regimen and managing side effects. Female clients described being prohibited from using PrEP by their partners and co-wives. From these results, we recommend that client-centred counselling stresses the prevention-effective adherence paradigm, which promotes PrEP use in risk periods that are identifiable and PrEP discontinuation when the risk period has finished. A national scale up of PrEP may mitigate problems accessing PrEP. Extended counselling and support could assist with adherence and the management of side effects. Education and support for partners and families of PrEP clients may also contribute to better PrEP continuation.
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Affiliation(s)
- Kate Bärnighausen
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Pascal Geldsetzer
- Faculty of Medicine, Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Stanford University School of Medicine, Stanford, CA, USA
| | - Sindy Matse
- Eswatini Ministry of Health, Mbabane, Eswatini
| | - Anita Hettema
- Clinton Health Access Initiative Eswatini, Mbabane, Eswatini
| | | | - Phiwa Dlamini
- Clinton Health Access Initiative Eswatini, Mbabane, Eswatini
| | - Mxolisi Mavuso
- Clinton Health Access Initiative Eswatini, Mbabane, Eswatini
| | - David Fakudze
- Clinton Health Access Initiative Eswatini, Mbabane, Eswatini
| | - Kathleen Kahn
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Till Bärnighausen
- Faculty of Medicine, Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Shannon A McMahon
- Faculty of Medicine, Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Heyns J, Van Huyssteen M, Bheekie A. The effectiveness of using text and pictograms on oral rehydration, dry-mixture sachet labels. Afr J Prim Health Care Fam Med 2021; 13:e1-e11. [PMID: 33970007 PMCID: PMC8111613 DOI: 10.4102/phcfm.v13i1.2646] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/06/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background Medication labels are often the only information available to patients after obtaining medication from a healthcare practitioner. Pictograms are graphic symbols that have shown to increase understanding of medicine use instructions. Aim To compare the accuracy of the interpretation of medicine use instructions from two different oral rehydration (OR) dry-mixture sachet labels – the control ‘routine textonly’ label and an experimental label with ‘text-and-pictograms’. Setting Participants were recruited from waiting rooms in public primary health care (PHC) facilities in Cape Town. Method Each participant was required to answer six questions about OR preparation. Response accuracy was determined by comparing the participant’s answer to the actual information written on the relevant label. Afterwards, participants could offer their opinion about the label and ways to improve their understanding. Results Of the 132 participants who were recruited, 67 were allocated to the experimental group and 65 to the control group. Only the significant difference between the experimental and control groups for the six questions regarding the label, was recorded for the answer that could be read from a single pictogram (p = 0.00) on the experimental group’s label. When asked about this question, more control participants (15/65) found the dosing instruction difficult to understand when compared to the experimental group (1/67). A third of the control participants (22/65) indicated that they could not see or locate instructions on the label. Conclusion Text and pictograms on written medicine labels may be an effective tool to aid understanding of medicine use instructions amongst patients attending PHC facilities.
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Affiliation(s)
- Jeanne Heyns
- School of Pharmacy, Faculty of Natural Science, Western Cape University, Bellville.
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Nualdaisri P, Corlett SA, Krska J. Provision and Need for Medicine Information in Asia and Africa: A Scoping Review of the Literature. Drug Saf 2021; 44:421-437. [PMID: 33666901 PMCID: PMC7994240 DOI: 10.1007/s40264-020-01038-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 11/23/2022]
Abstract
Published reviews of written medicine information (WMI) have mainly drawn on studies published in high-income countries, including very few Asian or African studies. We therefore set out to scope the research literature to determine the extent and type of studies concerning WMI for patients/consumers across these two continents. We sought empirical studies published between January 2004 and December 2019, conducted in any Asian or African country, as defined by the United Nations, in English or with an English abstract. The majority of the 923 papers identified were from high-income countries. We retained 26 papers from Africa and 99 from Asia. Most African studies (n = 20) involved patients in the development of PILs, in the assessment of the effectiveness of PILs or in surveys. In contrast, the highest proportion of Asian studies concerned the content of WMI (n = 42). WMI is desired, but needs to be in local languages, and there needs to be more use made of pre-tested pictograms. Existing WMI frequently does not meet local regulatory requirements, particularly locally manufactured products. A number of studies reported potentially positive impacts of providing WMI on knowledge and medicine use behaviours. Provision of medicine information is essential for safe use of medicines in all countries. Internationally agreed guidelines, incorporating good design principles, are needed to ensure the optimal content and design of WMI. The World Health Organization should support African and Asian regulatory bodies to share best practice in relation to WMI for patients/consumers and to develop and implement pan-continental guidelines that take into account consumer needs and preferences.
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Affiliation(s)
- Pitchaya Nualdaisri
- Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Thailand
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK
| | - Sarah A Corlett
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK
| | - Janet Krska
- Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK.
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Dowse R. Pharmacists, are words enough? The case for pictograms as a valuable communication tool. Res Social Adm Pharm 2020; 17:1518-1522. [PMID: 33139214 DOI: 10.1016/j.sapharm.2020.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/27/2020] [Accepted: 10/24/2020] [Indexed: 10/23/2022]
Abstract
Despite living in a visually saturated world, with visual content permeating seemingly every aspect of our lives, an area in which visuals are still under-represented is health communication. Written health information, including medicines information, has generally been reported as being reader-unfriendly, offering challenges and barriers to even the most literate of readers with its often lengthy, detailed documents, use of medical jargon, and densely packed small text. The inclusion of visual content in the form of pictograms offers the potential to enhance the attractiveness and reader-friendliness of the information as well as improving comprehension and recall of medicines and general health information. This commentary presents the case of pictograms as a valuable tool in medicines information, urging pharmacists to consider their adoption in practice, but also sounding a note of caution when using pictograms.
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Affiliation(s)
- Ros Dowse
- Faculty of Pharmacy, Rhodes University, P O Box 91, Makhanda/Grahamstown, 6140, South Africa.
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