Pictures Could Increase Medication Adherence in the Elderly

Older patients understood medication information more if it included pictograms.

Simple pictures included in medication instructions could help elderly adults understand how to properly adhere to the treatment, and prevent serious adverse events.

While physicians and pharmacists explain how to take certain medications, older patients may only remember a small portion of the instructions that were given. Elderly patients who require treatment with multiple medications can easily confuse treatment regimens, which could lead to hospitalization and even death in some cases.

The estimated cost of medication nonadherence ranges from $100 to 289 billion per year, the CDC has reported. Investigators now believe that including pictograms on written information could improve patient outcomes, and prevent unnecessary medical costs.

“Drugs are necessary to treat diseases and relieve symptoms, however, improper use of drugs can lead to serious consequences such as stomach bleeding and poisoning," said lead author Dr Annie Ng. “We wanted to see if supplementary pictograms could help older people understand how to take their medication safely.”

In a study published by Applied Ergonomics, investigators asked elderly adults to read medical instructions about 5 different drugs to determine if they were able to understand the information.

Included in the study were 50 individuals 65- to 84-years-old who took 1 of the 5 drugs. All patients had varying degrees of education, and had normal vision.

Investigators chose to conduct the study in older individuals, since they are more likely to be taking multiple drugs, and face a higher risk of adverse events.

“We focused on seniors but we believe this research could help a much wider demographic,” Dr Ng said. “People with vision problems or difficulties comprehending basic written information, for example, will be able to better understand their medication needs, which will help their health and support their independence.”

Individuals were randomized to receive the information in plain text or in plain text that was supplemented with pictograms. The pictograms depicted information such as “take with meals,” “do not leave in direct sunlight,” “poison,” and “do not leave near children,” according to the study.

Investigators found that the group receiving the pictograms understood the instructions better than the group that received plain text instructions. They also discovered that patients with less education had a decreased understanding of the information.

These findings suggest that seniors with lower levels of education need to be given extra accommodations to promote medication adherence. A simple and low-cost intervention, such as including pictograms in medication information, could have the potential to save the healthcare system money and improve patient health.

“Information on medicine labels can sometimes be confusing, especially if a patient has several medications to contend with. Including a few simple pictures on a medicine label helps older people to read and understand this information,” Dr Ng concluded. “This not only prevents accidental overdose, it relieves some of the pressure that our aging population is putting on the health service by avoiding preventable tragedies.”