Improving medication understanding among Latinos through illustrated medication lists.
OBJECTIVE
Strategies are needed to improve medication management among vulnerable populations. We tested the effect of providing illustrated, plain-language medication lists on medication understanding, adherence, and satisfaction among Latino patients with diabetes in a safety net clinic.


METHODS
Randomized controlled trial.


METHODS
Intervention patients received a PictureRx illustrated medication list that depicted the medication, indication, and dosing instructions, accompanied by plain language bilingual text. Usual care patients received a written list of their medications in their preferred language, with indication but no images. Outcomes were assessed by telephone approximately 1 week later. The Medication Understanding Questionnaire measured patients' ability to report the indication, strength, dosing, and frequency for their medication regimen. Self-reported adherence and satisfaction were secondary outcomes. Analysis was performed by intention to treat.


RESULTS
Of 200 enrolled participants, 197 (98.5%) completed follow-up. Most (71%) had not graduated high school, and 59% had low health literacy. Patients randomized to illustrated medication instructions had better overall understanding of their medications (P<.001), including greater ability to report the drug indication (P<.01), strength (P<.05), dosing (P<.01), and frequency of administration (P<.001). Self-reported adherence did not differ significantly between study groups. Patients who received illustrated medication lists were very satisfied with them.


CONCLUSIONS
In this randomized controlled trial, patients who received illustrated, plain-language medication lists demonstrated significantly greater understanding of their medication regimen. Such tools have the potential to improve medication use and chronic disease control, as well as reduce health disparities-although this requires further study.
Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322. E-mail: arun.mohan@emory.edu.
Arun
A
Mohan
Brian
B
Riley
Brian
B
Schmotzer
Dane R
DR
Boyington
Sunil
S
Kripalani
D032882:Comprehension; D003920:Diabetes Mellitus / Q000188:drug therapy; D004358:Drug Therapy; D005260:Female; D006630:Hispanic or Latino / Q000193:education*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008488:Medical Illustration; D055118:Medication Adherence / Q000208:ethnology; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*
D007004:Hypoglycemic Agents