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American Journal of Health-System Pharmacy, Vol. 63, Issue 23, 2391-2397
Copyright © 2006 by American Society of Health-System Pharmacists
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Special Features

Use of pictorial aids in medication instructions: A review of the literature

Marra G. Katz, Sunil Kripalani and Barry D. Weiss

MARRA G. KATZ, B.S., is medical student, New York Univeristy, New York. SUNIL KRIPALANI, M.D., M.SC., is Assistant Professor, Division of General Medicine, School of Medicine, Emory University, Atlanta, GA. BARRY D. WEISS, M.D., is Professor, Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson.

Address correspondence to Dr. Kripalani at the Division of General Medicine, School of Medicine, Emory University, 49 Jesse Hill Jr. Drive SE, Atlanta, GA 30303 (skripal{at}emory.edu).


Purpose. The effects of pictorial aids in medication instructions on medication recall, comprehension, and adherence are reviewed.

Summary. Many patients depend on medication labels and patient information leaflets for pertinent drug information, but these materials are often difficult for patients to understand. Research in psychology and marketing indicates that humans have a cognitive preference for picture-based, rather than text-based, information. Studies have shown that pictorial aids improve recall, comprehension, and adherence and are particularly useful for conveying timing of doses, instructions on when to take medicine, and the importance of completing a course of therapy. Other research has compared various techniques for using picture-based information and supports the use of integrative instructions, a combination of textual, oral, and pictorial communication, to promote comprehension and adherence. While pictures have generally proven useful for improving patient comprehension and adherence, not all picture-based interventions have produced successful results. Some icons, particularly clock icons, have been found to be too complex to enhance understanding and could not overcome the advantage provided by the familiarity of the textbased format, suggesting that patients be trained to use pictorial medication information before they are expected to use icons as an aid for medication administration. In addition to enhancing understanding, pictorial aids have been found to improve patients’ satisfaction with medication instructions.

Conclusion. The use of pictorial aids enhances patients’ understanding of how they should take their medications, particularly when pictures are used in combination with written or oral instructions.

Index terms: Compliance; Comprehension; Labels; Patient information; Patients; Pictograms; Prescriptions

 



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