Developing and user testing new pharmacy label formats-A study to inform labelling standards

Patient Information Leaflets of Drugs Used in Cardiometabolic Disorders: Suitability for Use by Older Persons

In the European Union, all medicines must include appropriate labelling and the respective patient information leaflet (PIL), which is the most reachable source of medicine's information for patients. This document includes a set of information understandable by their potential users and complementary to the information provided by health professionals. The ageing of the Portuguese population raises the need for the appropriateness of medicine's information for older consumers, taking into account their specific needs arising from physiological changes impacting drug action. This project aimed to analyse the content of medicines' PILs, specifically directed at older persons. A sample of medicines was selected considering the 100 active substances more consumed in Portugal by patients with chronic pathologies such as diabetes mellitus, hypertension, and dyslipidaemia. The analysis included readability, legibility, and content (directly and indirectly related to the use of medicines by older persons). A total of 69 PILs were analysed, and it was observed that the information provided about the drugs was included in most of these PILs (95.7%; n = 66) but without any specific information for patients belonging to different age groups. Signalling-specific warnings for older persons were only available in less than half of the PILs (46.4%; n = 32). The presence of relevant information on the appropriate use of the drug such as the recommended dose was only specified for older persons in 28% (n = 19) of the analysed PILs. The information available in PILs which can be considered as specifically directed to older persons is relatively scarce, even in areas as critical as the instructions for use. Hopefully, these results will contribute to increasing awareness regarding the need to adapt PILs' content to specific consumers and to test them to guarantee that they are adequate for all potential consumers.

Investigating the impact of patient-centred labels on comprehension of medication dosing: a randomised controlled trial

OBJECTIVE

This study aims to implement a version of patient-centred labels (PCL) consistent with current labelling practice in Australia; assess the effectiveness of PCL in relation to the proportion of participants that correctly comprehend dosing instructions, and explore the proportion of correct comprehension of PCL in participants with both low and high health literacy.

DESIGN

Randomised controlled trial.

SETTING

A large tertiary care hospital in Brisbane, Queensland, Australia.

PARTICIPANTS

121 participants with a majority born in Australia (65.3%), New Zealand (14.0%), the UK (6.6%) and Ireland (2.5%).

INTERVENTION

Participants were randomly assigned to either a panel of three PCL (n=61) or three standard labels (n=60) and asked to comprehend their assigned panel of labels.

OUTCOME MEASURES

Difference in the proportion of participants that correctly comprehend dosing instructions provided on PCL compared with standard labels. The two-proportion test was used to measure the impact of PCL on the proportion of participants correctly comprehending dosing instructions.

RESULTS

A greater proportion of participants were able to accurately comprehend PCL compared with standard labels. The proportion of participants who were able to correctly comprehend dose instructions provided on all three labels was significantly higher in the group that received PCL; 23.3% standard vs 83.6% PCL, p<0.001. The effect was observed in both low and high health literacy participants. The proportion of participants with accurate label comprehension was higher in participants with low Newest Vital Signs scores (8.3% standard vs 85.7% PCL, p<0.001) and low Rapid Estimate of Adult Literacy in Medicine scores (10.5% standard vs 96.0% PCL, p<0.001) who received PCL.

CONCLUSION

This study supports the use of PCL in Australian pharmacy practice. PCL provide simple, clear and explicit dosing instructions to patients. Implementing PCL may reduce the risk of misinterpreting dosing instructions by patients and improve quality use of medicines.

TRIAL REGISTRATION NUMBER

ACTRN12621000083897; Results.