title: Preparation, validation and user-testing of pictogram-based patient information leaflets for hemodialysis patients.
abstract: BACKGROUND
  Patient information leaflets are universally-accepted resources to educate the patients/users about their medications, disease and lifestyle modification.
  
  
  OBJECTIVE
  The objective of the study was to prepare, validate and perform user-testing of pictogram-based patient information leaflets (P-PILs) among hemodialysis (HD) patients.
  
  
  METHODS
  The P-PILs are prepared by referring to the primary, secondary and tertiary resources. The content and pictograms of the leaflet have been validated by an expert committee consisting of three nephrologists and two academic pharmacists. The Baker Able Leaflet Design has been applied to develop the layout and design of the P-PILs.
  
  
  RESULTS
  Quasi-experimental pre- and post-test design without control group was conducted on 81 HD patients for user-testing of P-PILs. The mean Baker Able Leaflet Design assessment score for English version of the leaflet was 28, and 26 for Kannada version. The overall user-testing knowledge assessment mean scores were observed to have significantly improved from 44.25 to 69.62 with p value <0.001.
  
  
  CONCLUSIONS
  The overall user opinion of content and legibility of the leaflets was good. Pictogram-based patient information leaflets can be considered an effective educational tool for HD patients.
authors.affiliation: Department of Pharmacy Management, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal 576104, Karnataka, India.
authors.forename: Uday Venkat
authors.initials: UV
authors.lastname: Mateti
authors.affiliation: Department of Pharmacy Management, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal 576104, Karnataka, India.
authors.forename: Anantha Naik
authors.initials: AN
authors.lastname: Nagappa
authors.affiliation: Departments of Nephrology, Kasturba Medical College, Kasturba Hospital, Manipal University, Manipal 576104, Karnataka, India.
authors.forename: Ravindra Prabhu
authors.initials: RP
authors.lastname: Attur
authors.affiliation: Departments of Nephrology, Kasturba Medical College, Kasturba Hospital, Manipal University, Manipal 576104, Karnataka, India.
authors.forename: Manohar
authors.initials: M
authors.lastname: Bairy
authors.affiliation: Departments of Nephrology, Kasturba Medical College, Kasturba Hospital, Manipal University, Manipal 576104, Karnataka, India.
authors.forename: Shankar Prasad
authors.initials: SP
authors.lastname: Nagaraju
authors.affiliation: Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal 576104, Karnataka, India.
authors.forename: Surulivelrajan
authors.initials: S
authors.lastname: Mallayasamy
authors.affiliation: Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal 576104, Karnataka, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Vilakkathala
authors.affiliation: Department of Statistics, Manipal University, Manipal 576104, Karnataka, India.
authors.forename: Vasudev
authors.initials: V
authors.lastname: Guddattu
authors.affiliation: Department of Health Management and Policy, Center for Global Health and College of Pharmacy, University of Michigan, MI, USA.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
keywords: Hemodialysis; Leaflets; Patient education; User testing