How often do you have to re-read the label on your prescription container just to understand basic instructions? Patient misunderstanding and misuse of medications result in more than 1 million adverse drug events per year in the United States. Many patients recover from these events but, in some cases, hospitalization or even death has occurred.
The Institute of Medicine states that more than a third of U.S. adults, or roughly 77 million people, have “limited health literacy,” which includes the inability to comprehend such prescription label instructions. Low health literacy rates are most common among non-English speakers, seniors and those from disadvantaged families. With more than 19 percent of Georgia’s population living below the poverty line, and 10 percent of citizens over the age of 65, this is a serious public health risk.
Patients’ best source of information regarding their medications is on the prescription container label. But today’s labels are needlessly complicated. Fonts are small, and letters are too close together. Instructions are sometimes unclear, lengthy and use complex terms; that can be dangerous. For example, when would “take as directed” actually provide any useful information to a patient?
Inconsistency reigns, as these labels — including how they are organized, how dosage instructions are presented, and which information is included — differ from state to state, pharmacy to pharmacy, and sometimes even from medication to medication filled by the same pharmacy.
With nearly half of patients misunderstanding instructions, we need to do better.
Recently, the U.S. Pharmacopeial Convention, a nonprofit group that develops standards for pharmaceuticals, released the first-ever universal standards to be applied to these labels. They provide specific direction on how to organize a label in a “patient-centered” manner that reflects how most patients seek out and understand medication instructions.
Key elements include prominently displaying the information most critical to using the medicine safely and effectively (for example, the patient’s name, drug brand/generic name, dose); using simple language; providing explicit instructions for use (for instance, “take 2 tablets in the morning and 2 tablets in the evening” instead of “take two tablets twice daily”); improving readability by using bigger, cleaner fonts; including the drug’s purpose for use in simple terms (such as, “for high blood pressure,” as opposed to “for hypertension”); and providing alternatives for patients who are visually impaired or have limited English proficiency.
Setting these standards was just the first step. Some pharmacies have begun to adopt patient-centered labels, but for most Americans to benefit, these standards need to be adopted by state boards of pharmacy, as the National Association of Boards of Pharmacy has recommended.
While we understand that putting these standards into practice will take some initial work on the part of pharmacies, the long-term benefits are immeasurable.
Dr. Ruth Parker is a professor of medicine, pediatrics and public health at Emory University. Dr. Roger L. Williams is chief executive officer of the U.S. Pharmacopeial Convention.
