Human factors and ergonomics methods for pharmacy research and clinical practice

BACKGROUND

Human factors and ergonomics (HFE) is a scientific and practical human-centered discipline that studies and improves human performance in sociotechnical systems. HFE in pharmacy promotes the human-centered design of systems to support individuals and teams performing medication-related work.

OBJECTIVE

To review select HFE methods well suited to address pharmacy challenges, with examples of their application in pharmacy.

METHODS

We define the scope of HFE methods in pharmacy as applications to pharmacy settings, such as inpatient or community pharmacies, as well as medication-related phenomena such as medication safety, adherence, or deprescribing. We identify and present seven categories of HFE methods suited to widespread use for pharmacy research and clinical practice.

RESULTS

Categories of HFE methods applicable to pharmacy include work system analysis; task analysis; workload assessment; medication safety and error analysis; user-centered and participatory design; usability evaluation; and physical ergonomics. HFE methods are used in three broad phases of human-centered design and evaluation: study; design; and evaluation. The most robust applications of HFE methods involve the combination of HFE methods across all three phases. Two cases illustrate such a comprehensive application of HFE: one case of medication package, label, and information design and a second case of human-centered design of a digital decision aid for medication safety.

CONCLUSIONS

Pharmacy, including the places where pharmacy professionals work and the multistep process of medication use across people and settings, can benefit from HFE. This is because pharmacy is a human-centered sociotechnical system with an existing tradition of studying and analyzing the present state, designing solutions to problems, and evaluating those solutions in laboratory or practice settings. We conclude by addressing common concerns about the implementation of HFE methods and urge the adoption of HFE methods in pharmacy.

A Comparison of Older vs. Newer Over-the-Counter (OTC) Nonprescription Drug Labels on Search Time Accuracy

The present study evaluated response time and accuracy to answer a series of questions of information in 16 (8 older and 8 newer ‘Drug Facts’) over-the-counter (OTC) drug labels. The newer labels include aspects, based on previous research, which should benefit performance. The results indicated that participant's response times were significantly faster with the newer labels compared to the older ones. However, this was not true of all OTC product samples. Accuracy was high (error rate low) for both label formats. Response times for females were significantly faster than males for both label types. The benefits of formatting text for facilitating information acquisition from drug labels and other kinds of printed information are discussed.

'It's all there in black and white' - or is it? Consumer perspectives on the proposed Australian Medicine Information Box over-the-counter label format

Background

Over‐the‐counter (OTC) labels help support safe medication use by consumers. In 2012, the Australian Therapeutic Goods Administration (TGA) released a consultation paper proposing OTC label standardization to improve label quality via implementation of the Medicine Information Box (MIB) label. However, consumer opinions of the MIB and standardization of OTC labelling remain unexplored.

Objective

To explore consumer perspectives of OTC label standardization and the proposed MIB.

Design

Mock MIB labels were developed by the research team, guided by the TGA consultation paper, and used as interview stimulus material.

Participants and setting

Semi‐structured interviews were conducted with 38 Australian and 39 UK adult participants. Participant perspectives on OTC label standardization, opinions on the MIB and perceived improvements were explored. All interviews were audio‐recorded with permission, transcribed verbatim, and the content thematically analysed.

Results

Participants expressed a range of opinions towards OTC label standardization, from welcoming standardization to concern that important details may be overlooked. The MIB was generally positively received due to its perceived good information design and ease of navigation. Participants requested reordering of information‐specifically, for the active ingredient to be moved to a less prominent position. Suggested improvements centred on content and design changes, for example colour, pictograms, bolding.

Conclusions

Participants felt positively towards OTC label standardization and saw the MIB as a feasible standardized format to implement for OTC labels. Although they appreciated its good information design, they felt further improvements to its content and design are required to enhance its quality and usability.

Research-based guidelines for warning design and evaluation

During the past two decades, the body of empirical research on warning design and evaluation has grown. Consequently, there are now basic principles and guidelines addressing warning design (e.g., signal words, color, symbols, and text/content), placement (e.g., location within product instructions), and how to enhance the usability of designs by considering factors internal to the user (e.g., beliefs, perceptions of risk, stress). Similarly, evaluation methods have been developed that can be used to measure the effectiveness of warnings such as the degree to which warnings are communicated to recipients and the degree to which they encourage or influence behavioral compliance. An overview of the empirical literature on warning guidelines and evaluation approaches is provided. Researchers, practitioners, and manufacturers can use these guidelines in various contexts to reduce the likelihood that injury and product damage from exposure to a hazard will occur.