Improving patient understanding of prescription drug label instructions.
BACKGROUND
Patient misunderstanding of instructions on prescription drug labels is common and a likely cause of medication error and less effective treatment.


OBJECTIVE
To test whether the use of more explicit language to describe dose and frequency of use for prescribed drugs could improve comprehension, especially among patients with limited literacy.


METHODS
Cross-sectional study using in-person, structured interviews.


METHODS
Three hundred and fifty-nine adults waiting for an appointment in two hospital-based primary care clinics and one federally qualified health center in Shreveport, Louisiana; Chicago, Illinois; and New York, New York, respectively.


METHODS
Correct understanding of each of ten label instructions as determined by a blinded panel review of patients' verbatim responses.


RESULTS
Patient understanding of prescription label instructions ranged from 53% for the least understood to 89% for the most commonly understood label. Patients were significantly more likely to understand instructions with explicit times periods (i.e., morning) or precise times of day compared to instructions stating times per day (i.e., twice) or hourly intervals (89%, 77%, 61%, and 53%, respectively, p < 0.001). In multivariate analyses, dosage instructions with specific times or time periods were significantly more likely to be understood compared to instructions stating times per day (time periods--adjusted relative risk ratio (ARR) 0.42, 95% Confidence Interval (CI) 0.34-0.52; specific times--ARR 0.60, 95% CI 0.49-0.74). Low and marginal literacy remained statistically significant independent predictors of misinterpreting instructions (low--ARR 2.70, 95% CI 1.81-4.03; marginal--ARR 1.66, 95% CI 1.18-2.32).


CONCLUSIONS
Use of precise wording on prescription drug label instructions can improve patient comprehension. However, patients with limited literacy were more likely to misinterpret instructions despite use of more explicit language.
Davis
Terry C
TC
Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
Federman
Alex D
AD
Bass
Pat F
PF
Jackson
Robert H
RH
Middlebrooks
Mark
M
Parker
Ruth M
RM
Wolf
Michael S
MS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods / Q000592:standards; D032882:Comprehension; D003430:Cross-Sectional Studies; D004348:Drug Labeling / Q000379:methods / Q000592:standards* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards*; D055553:Prescription Drugs / Q000592:standards*; D055815:Young Adult
D055553:Prescription Drugs