title: Can improved prescription medication labeling influence adherence to chronic medications? An evaluation of the Target pharmacy label.
abstract: BACKGROUND
  Prescription medication labels contain valuable health information, and better labels may enhance patient adherence to chronic medications. A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve readability and understanding.
  
  
  OBJECTIVE
  We evaluated whether the new Target label influenced patient medication adherence.
  
  
  METHODS
  Using claims from two large health plans, we identified patients with one of nine chronic diseases who filled prescriptions at Target pharmacies and a matched sample who filled prescriptions at other community pharmacies.
  
  
  METHODS
  We stratified our cohort into new and prevalent medication users and evaluated the impact of the Target label on medication adherence. We used linear regression and segmented linear regression to evaluate the new-user and prevalent-user analyses, respectively.
  
  
  RESULTS
  Our sample included 23,745 Target users and 162,368 matched non-Target pharmacy users. We found no significant change in adherence between new users of medications at Target or other community pharmacies (p = 0.644) after implementing the new label. In prevalent users, we found a 0.0069 percent reduction in level of adherence (95% CI -0.0138-0.0; p < 0.001) and a 0.0007 percent increase in the slope in Target users (the monthly rate of change of adherence) after implementation of the new label (95% CI 0.0001-0.0013; p = 0.001).
  
  
  CONCLUSIONS
  We found no changes in adherence of chronic medication in new users, and small and likely clinically unimportant changes in prevalent users after implementation of the new label. While adherence may not be improved with better labeling, evaluation of the effect of labeling on safety and adverse effects is needed.
authors.affiliation: Department of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street (Suite 3030), Boston, MA 02120, USA. wshrank@partners.org
authors.forename: William H
authors.initials: WH
authors.lastname: Shrank
authors.forename: Patrick P
authors.initials: PP
authors.lastname: Gleason
authors.forename: Claire
authors.initials: C
authors.lastname: Canning
authors.forename: Carol
authors.initials: C
authors.lastname: Walters
authors.forename: Alan H
authors.initials: AH
authors.lastname: Heaton
authors.forename: Saira
authors.initials: S
authors.lastname: Jan
authors.forename: Amanda
authors.initials: A
authors.lastname: Patrick
authors.forename: M Alan
authors.initials: MA
authors.lastname: Brookhart
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schneeweiss
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Solomon
authors.forename: Jerry
authors.initials: J
authors.lastname: Avorn
authors.forename: Niteesh K
authors.initials: NK
authors.lastname: Choudhry
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003157:Community Pharmacy Services / Q000592:standards*; D004348:Drug Labeling / Q000379:methods / Q000592:standards*; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D013997:Time Factors