Although illustrated medication instructions may improve medication management among vulnerable populations, little prior research has evaluated their use among Latinos. We conducted focus groups and interviews with Latino patients with diabetes at two safety net clinics in Tennessee to understand medication taking practices and perceptions of illustrated medication instructions. Patients reported confidence in being able to take medications, but demonstrated a lack of understanding of medication instructions. On further probing, they described several barriers to effective medication management rooted in poor communication. Patients expressed preference for illustrated medication instructions which could address several of the challenges raised by patients.
Research shows that prescription drug labels are often difficult for patients to understand, which contributes to medication errors and nonadherence. In this study, the authors developed and qualitatively evaluated an evidence-based bilingual prescription container label designed to improve understanding. The authors developed several prototypes in English only or in English and Spanish. The labels included an image of the drug, an icon to show its purpose, and plain-language instructions presented in a 4-time-of-day table. In 5 focus groups and interviews that included 57 participants, patients and pharmacists critically reviewed the designs and compared them with traditional medication labels and reformatted labels without illustrations. Patients strongly preferred labels that grouped patient-relevant content, highlighted key information, and included drug indication icons. They also preferred having the 4-time-of-day table and plain-language text instructions as opposed to either one alone. Patients preferred having pertinent warnings on the main label instead of auxiliary labels. Pharmacists and Latino patients valued having Spanish and English instructions on the label, so both parties could understand the content. The final label design adheres to the latest national- and state-level recommendations for label format and incorporates additional improvements on the basis of patient and pharmacist input. This design may serve as a prototype for improving prescription drug labeling.
Objectives To describe (1) the role of illustrated medication instructions in pharmacy practice, (2) the evidence for their use, and (3) our experience with their implementation. Practice description PictureRx is applicable to all pharmacy practice settings. Practice innovation PictureRx enables pharmacists to rapidly produce evidence-based, illustrated medication instructions that are well-understood by patients of all health literacy levels. Results PictureRx has been studied in a number of settings. The tool was successfully deployed at a busy, outpatient pharmacy; in a medical clinic for the underserved; and pilot-tested among elderly, community dwelling Medicare recipients. In each of these settings, PictureRx was received favorably by patients, pharmacists, and other health care providers. It improved patients’ satisfaction with the pharmacy and knowledge about their medications. Ongoing research is assessing whether PictureRx enhances medication management among Latinos. Conclusion PictureRx helps pharmacists address challenges related to low health literacy and can be implemented into a broad range of practices environments. Ongoing research will delineate the extent to which PictureRx reduces health disparities.
Use of a tablet computer application to engage patients in updating their medication list Purpose. Failure to obtain an accurate medication history can adversely affect patient care in the emergency department (ED) and propagate errors into the inpatient and outpatient settings. Obtaining an accurate medication history in the ED is challenging, however, due to limited time, a suboptimal environment for patient interaction, and inadequate information in the electronic health record (EHR). This article describes the development and initial evaluation of the PictureRx Medication History Application, a tablet computer-based program that queries patients' prescription fill data from the Surescripts Medication History service and renders it graphically for review and editing at the point of care.Methods. A quasi-experimental trial of PictureRx was performed in a large academic ED. Adult patients taking at least 1 prescription medication were prospectively eligible for the intervention. Usual care control patients were retrospectively matched 1:1. The main outcomes were updates to the patients' existing pre-visit medication list in the EHR and patient perceptions of the application.Results. The medication list was updated for 101/244 (41.4%) of the intervention group and for 43/244 (17.6%) of the control group (difference 23.8%, 95% confidence interval, 16.0-31.6%). Similar differences were observed for medication additions, removals, and corrections in dose. Approximately 80% of intervention patients "strongly agreed" that the application was easy to use, aided medication list accuracy, and the graphical features assisted with recall. Conclusion.A novel tablet computer-based medication history application was feasible to implement in a busy academic ED. Use of the tool was associated with more updates to patients' EHR medication list.
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