Effect of Standardized, Patient-Centered Label Instructions to Improve Comprehension of Prescription Drug Use

• Type of Material: Article
• Authors: Michael S. Wolf, Northwestern University; Terry C. Davis, Louisiana State University; Laura M. Curtis, Northwestern University; Jennifer A. Webb, Northwestern University; Stacy Cooper Bailey, Northwestern University; William H. Shrank, Harvard University; Lee Lindquist, Northwestern University; Bernice Ruo, Northwestern University; Mary V. Bocchini, Louisiana State University; Ruth M Parker, Emory University; Alastair J. J. Wood, Symphony Capital, LLC
• Language: English
• Date: 2011-01-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010 by Lippincott Williams & Wilkins.
• Final Published Version (URL): http://dx.doi.org/10.1097/MLR.0b013e3181f38174
• Title of Journal or Parent Work: Medical Care
• ISSN: 0025-7079
• Volume: 49
• Issue: 1
• Start Page: 96
• End Page: 100
• Grant/Funding Information: Supported by the Agency for Healthcare Research and Quality (R01 HS017687; R01 HS019435; PI: Wolf); and an unrestricted grant from Target Corporation.
• Keywords: labels; Health Policy & Services; LOW-LITERACY; QUALITY; Public, Environmental & Occupational Health; OLD ADULTS; medication; MEMORY; patient; prescription; comprehension; INFORMATION; VARIABILITY; Science & Technology; ADHERENCE; WARNING LABELS; ICONS; safety; health literacy; Life Sciences & Biomedicine; YOUNG; Health Care Sciences & Services
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Pharmacology; Health Sciences, Medicine and Surgery

Abstract

Objective: To evaluate the effectiveness of standardized, patient-centered label (PCL) instructions to improve comprehension of prescription drug use compared with typical instructions. Methods: A total of 500 adult patients recruited from 2 academic and 2 community primary care clinics in Chicago, IL and Shreveport, LA were assigned to receive as follows: (1) standard prescription instructions written as times per day (once, twice 3 times per day) (usual care), (2) PCL instructions that specify explicit timing with standard intervals (morning, noon, evening, bedtime) (PCL), or (3) PCL instructions with a graphic aid to visually depict dose and timing of the medication (PCL + Graphic). The outcome was correct interpretation of label instructions. Results: Instructions with the PCL format were more likely to be correctly interpreted compared with standard instructions (adjusted relative risk [RR]: 1.33, 95% confidence interval [CI]: 1.25-1.41). Inclusion of the graphic aid (PCL + Graphic) decreased rates of correct interpretation compared with PCL instructions alone (RR: 0.93; 95% CI: 0.89-0.97). Patients with low literacy were better able to interpret PCL instructions (low literacy: RR: 1.39; 95% CI: 1.14-1.68; P = 0.001). Conclusion: The PCL approach could improve patients' understanding and use of their medication regimen.