Icons Improve Older and Younger Adults' Comprehension of Medication Information

Abstract

We examined whether timeline icons improved older and younger adults' comprehension of medication information. In Experiment 1, comprehension of instructions with the icon (icon/text format) and without the icon (text-only format) was assessed by questions about information that was (a) implicit in the text but depicted explicitly by the icon (total dose in a 24 hour period), (b) stated and depicted in the icon/text condition (medication dose and times), and (c) stated but not depicted by the icon (e.g., side effects). In a separate task, participants also recalled medication instructions (with or without the icon) after a study period. We found that questions about dose and time information were answered more quickly and accurately when the icon was present in the instructions. Notably, icon benefits were greater for information that was implicit rather than stated in the text. This finding suggests that icons can improve older and younger adults' comprehension by reducing the need to draw some inferences. The icon also reduced effective study time (study time per item recalled). In Experiment 2, icon benefits did not occur for a less integrated version of the timeline icon that, like the text, required participants to integrate dose and time information in order to identify the total daily dose. The integrated version of the icon again improved comprehension, as in Experiment 1, as well as drawing inferences from memory. These findings show that integrated timeline icons improved comprehension primarily by aiding the integration of dose and time information. These findings are discussed in terms of a situation model approach to comprehension.

The Influence of Symbols on the Short-Term Recall of Pharmacy-Generated Prescription Medication Information in a Low Health Literate Sample

“…The effect of symbols and pictures on conveying health information has been studied in a variety of contexts and in several different populations (e.g., Delp & Jones, 1996;Dowse & Ehlers, 2003a, 2003bDowse & Ehlers, 2005;Hameen-Antila, Kemppainen, Enlund, Patricia, & Marja, 2004;Hanson, 1995;Hanson & Hartzema, 1995;Mansoor & Dowse, 2003;Morrow, Hier, Menard, & Leirer, 1998;Morrow et al, 2005;Ngoh & Shepherd, 1997;Sansgiry, Cady, & Adamcik, 1997;Sojourner & Wogalter, 1997. For example, studies show that symbols may improve recall (Hanson & Hartzema, 1995;Houts et al, 1998;Houts, Witmer, Egeth, Loscalzo, & Zabora, 2001) and comprehension of (Delp & Jones, 1996;Dowse & Ehlers, 2004, 2005Hanson & Hartzema, 1995;Hardie, Gagnon, & Eckel, 1979;Mansoor & Dowse, 2003;Ngoh & Shepherd, 1997;Schillinger et al, 2005) as well as adherence to important medical instructions among patients with limited literacy skills (Delp & Jones, 1996;Dowse & Ehlers, 2005;Hanson, 1995;Hardie et al, 1979;Ngoh & Shepherd, 1997;Schillinger et al, 2005).…”

Improving Medication Knowledge Among Older Adults With Heart Failure: A Patient-Centered Approach to Instruction Design

“…Finally, the presentation format of the instructions should also improve comprehension because we reinforced the text by icons that conveyed medication name, dose, and schedule. Combined icontext formats improve older adults' memory for procedural instructions (Morrell & Park, 1993) and medication instructions (Morrow, Hier, Menard, & Leirer, 1998).…”

Health Literacy and Quality: Focus on Chronic Illness Care and Patient Safety

“…100 The interpretation of weight-and age-based dosing charts for OTC medicines is particularly difficult for caregivers with limited literacy or numeracy skills. Pictorial-enhanced written materials have been shown to improve comprehension, adherence, and dosing accuracy, 93,98,[107][108][109][110] particularly for patients with low literacy skills. [111][112][113][114] The use of illustrated schedules to assist patients with medication selfmanagement 108,115 can be especially beneficial for patients who take multiple medications.…”

“…[111][112][113][114] The use of illustrated schedules to assist patients with medication selfmanagement 108,115 can be especially beneficial for patients who take multiple medications. These picture-based scheduling tools seem to aid in the integration of dose and time information, 108 have been well accepted by patients, and are particularly beneficial for those with limited literacy or decreased cognitive function. 115 Use of photographs and audiovisual and multimedia aids is another potential strategy for improving patient/caregiver understanding of medication instructions, particularly when medication regimens are complex, such as those for children with chronic diseases.…”