Abstract
Introduction
The search for new ways to optimize the use of medications by patients has led the pharmaceutical community to promote the idea of introducing pictograms into routine practice. The main intention of pictograms is to ease patient adherence and to reduce potential risks or errors associated with the use of medications.
Purpose
To evaluate a series of pharmaceutical pictograms for patient comprehension.
Patients and methods
The study was conducted in community pharmacies within a European Union country that belongs to the professional research network. Structured interviews were used to evaluate the pictograms for patient comprehension. This consisted of an assessment of the following: the transparency and translucency of the pictograms, health literacy, and pictogram recall. Participants were also given the opportunity to provide feedback on how to improve the pictograms. The primary endpoint was pictogram comprehension. Secondary outcomes included recall of the pictograms and pictogram translucency.
Results
The study included 68 patients with whom face-to-face interviews were performed. Low transparency results (≤25%) and extensive patient feedback in initial interviews led to the withdrawal of certain pictograms (n=15) from the evaluation. Among the pictograms included in the final stage of our research, 22 pictograms (62.8%) obtained an acceptable transparency level ≥66%. All pictograms passed the short-term recall test with positive results.
Conclusion
A majority of the designed and modified pictograms reached satisfactory guess-ability scores. Feedback from patients enabled modification of the pictograms and proved that patients have an important voice in the discussion regarding the design of additional pictograms.
Acknowledgments
The pictogram validation study was sponsored by the Warsaw-based Piktorex Sp. z.o.o., which has received financial support from the LQT Fund S.A. in Gdansk and from The National Centre of Research and Development in Warsaw, on the basis of the Contract on Support within the Systemic Project “Bridge Alfa”, concluded on December 3, 2015. This financial support is nonrefundable public aid within the meaning of section § 30 Paragraph 3 in relation to section § 31 of the Regulation of the Minister of Education and Higher Education of February 25, 2015, regarding conditions for granting public aid, and de minimis aid by The National Centre of Research and Development (reference number of the aid program SA. 35857 [2012/X]), exempt from notification obligation, provided for in Art. 108 of the Treaty on the functioning of the European Union, pursuant to Art. 21 of the Commission Regulation (EU) number 651/2014 of June 14, 2014, declaring certain categories of aid compatible with the internal market in application of Articles 107 and 108 of the Treaty. All pictograms developed in the project are owned and registered in the Polish Patent Office. It must be emphasized that this publication was created by Piktorex Sp. z.o.o. as a result of obligatory conditions to obtain financial support from the LQT Fund S.A. in Gdansk and from The National Centre of Research and Development in Warsaw, on the basis of the Contract on Support within the Systemic Project “Bridge Alfa”, concluded on December 3, 2015. A Polish version of the Newest Vital Sign questionnaire was prepared by Słońska Z, Borowiec A, and Lignowska L, based on the reference of Rowlands et al,Citation14 as part of the European Health Literacy Survey.Citation27
Author contributions
PM designed the study and supervised the project, DŚ designed the study, and prepared the manuscript, MB and ED collected the data, and JK, AP, RV, and MJ supervised the project. All authors had a substantial role in the completed study, contributed to the manuscript in a significant manner, and contributed toward data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
PM is a research assistant at the Department of Pharmaceutical Technology, Collegium Medicum in Bydgoszcz, Nicolaus University in Torun, and is a current employee of Piktorex Sp. z.o.o. DŚ has received an honorarium from Piktorex Sp. z.o.o. MB and ED are current employees of Farenta Polska. The authors report no other conflicts of interest in this work.