title: Instructions for masking the taste of medication for children: Validation of a pictogram tool.
abstract: BACKGROUND
  Medications that taste unpleasant can be a struggle to administer to children, most often resulting in low adherence rates. Pictograms can be useful tools to improve adherence by conveying information to patients in a way that they will understand.
  
  
  METHODS
  One-on-one structured interviews were conducted with parents/guardians and with children between the ages of 9 and 17 years at a pediatric hospital. The questionnaire evaluated the comprehension of 12 pictogram sets that described how to mask the taste of medications for children. Pictograms understood by >85% of participants were considered validated. Short-term recall was assessed by asking participants to recall the meaning of each pictogram set.
  
  
  RESULTS
  There were 51 participants in the study-26 (51%) were children aged 9 to 17 years and 25 (49%) were parents or guardians. Most children (54%) had health literacy levels of grade 10 or higher. Most parents and guardians (92%) had at least a high school health literacy level. Six of the 12 pictogram sets (50%) were validated. Eleven of 12 pictogram sets (92%) had a median translucency score greater than 5. All 12 pictogram sets (100%) were correctly identified at short-term recall and were therefore validated.
  
  
  CONCLUSIONS
  The addition of validated illustrations to pharmaceutical labels can be useful to instruct on how to mask the taste of medication in certain populations. Further studies are needed to assess the clinical impact of providing illustrated information to populations with low health literacy.
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario.
authors.forename: Régis
authors.initials: R
authors.lastname: Vaillancourt
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario.
authors.forename: Yen
authors.initials: Y
authors.lastname: Truong
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario.
authors.forename: Shazya
authors.initials: S
authors.lastname: Karmali
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario.
authors.forename: Amanda
authors.initials: A
authors.lastname: Kraft
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario.
authors.forename: Selina
authors.initials: S
authors.lastname: Manji
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario.
authors.forename: Gilda
authors.initials: G
authors.lastname: Villarreal
authors.affiliation: Children's Hospital of Eastern Ontario, Ottawa, Ontario.
authors.forename: Annie
authors.initials: A
authors.lastname: Pouliot