Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Drug labels are prescriptions for mistakes

01.12.2006
Lower literacy, multiple medications associated with medical misunderstanding

A new study to assess understanding of five common prescription label instructions found that patients had difficulty comprehending how much and how often the medication should be taken. Misunderstanding was particularly high among those with lower literacy (eighth grade level or below) and those who took many prescription drugs.

The study, “To Err is Truly Human: Literacy and Misunderstanding of Prescription Drug Labels,” is scheduled for online release to the public by Annals of Internal Medicine on November 29, 2006, at www.annals.org. The article also will be printed in the December 19 issue of Annals of Internal Medicine.

The researchers interviewed 395 English-speaking adults in three states. The five medications identified for the study were two antibiotics (amoxicillin and trimethoprim); an expectorant (guaifenesin); an anti-hypertensive, channel blocking agent (felodipine); and a diuretic (furosemide). Patient literacy was classified either as low (sixth grade and below), marginal (seventh to eighth grade), or adequate (ninth grade and higher).

Study findings included:

- Although 70.7 percent of patients with low literacy correctly stated the instructions “Take two tablets by mouth twice daily,” only 34.7 percent could demonstrate the number of pills to be taken daily.

- The rates of understanding individual labels ranged from 67.1 percent for the instructions for trimethoprim (“Take one tablet by mouth twice daily for seven days”) to 91.1 percent for the instructions on the label for felodipine (“Take one tablet by mouth once each day”).

- Patients with low literacy were less able to understand the meaning of all five medication labels than those with adequate literacy.

- The majority (51.8 percent) of incorrect patient responses reflected an error in dosage (e.g., tablespoon vs. teaspoon), and 28.2 percent stated the wrong dose frequency (e.g., “One tablet each day for seven days” instead of “Take one tablet by mouth twice daily for seven days”).

- Most patients did not pay attention to the auxiliary (warning) labels (e.g., “Do Not Take Dairy Products Within One Hour Of This Medication”) and those with low literacy were more likely to ignore them.

Health literacy expert and lead author Terry C. Davis, PhD, chairperson of the American College of Physicians Foundation’s (ACPF) Patient-Centered Health Literacy Advisory Board, and the study co-authors discussed the findings today at the ACP Foundation’s National Health Communication Conference in Washington, DC.

“Medication error is the most common medical mistake,” said Davis, a pioneer in the health literacy field. “Most of the research has looked at the mistakes of healthcare providers. In looking at patients, we found it was common for them to make mistakes when dosing medicine for themselves, their elderly parents, or their children.”

Despite a degree in philosophy, 61-year old Buddy Landry had trouble understanding a label for a prescription antibiotic, which allowed an infection to continue.

“The prescription was a bottle of 30 pills and it said that I could have ‘two refills over the next year,’ which I figured was in case I had a recurrence of the same problem,” said Landry. “After a week or two my infection ‘returned’ because I didn’t realize that I was supposed to refill the prescription as soon as I finished each bottle.”

Davis recommends that physicians provide specific instructions to patients about how to take the medicine.

“For example, saying ‘take one pill at 8:00 a.m. and one pill at 8:00 p.m.’ is better than saying ‘take one pill every 12 hours,’ which is confusing to a lot of patients,” said Davis.

The study indicates that currently recommended methods for confirming patient understanding, such as the “teach-back” technique in which patients are asked to repeat instructions to demonstrate their understanding, may be inadequate for identifying potential errors in medication administration.

“For those interested in improving health care quality and safety for vulnerable populations, this multisite study has important implications for practice, research, and policy,” wrote Dean Schillinger, MD, in a separate editorial. “Because the framework for regulating the content of prescription labels and accompanying materials is inadequate, patients and clinicians are suffering. With this study, the genie is out of the bottle.”

To improve health literacy, the researchers recommend that the text and format of existing primary and auxiliary labels on prescription medication containers should be redesigned and standardized. Less complex and more explicit dosing instructions may ultimately improve patient understanding. Furthermore, a system approach in which a healthcare professional verifies that patients can accurately demonstrate or articulate specific correct medication taking behaviors is important to ensure quality care.

“The study shows that patients of all ages would benefit from additional efforts to improve the clarity and comprehensibility of labeling on prescription drugs,” said Davis. “With Americans taking more prescription medications annually, the incidence of patient medication errors is likely to rise.”

The researchers noted some limitations with the study. The association between misunderstanding and medication error was not examined. Patients’ actual prescription drug-taking behaviors were not studied. The study population was at high risk for poor health outcomes. Most participants were women, and participation was limited to those who were proficient in English only.

Steve Majewski | EurekAlert!
Further information:
http://www.acponline.org

More articles from Studies and Analyses:

nachricht A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg

nachricht Urbanization to convert 300,000 km2 of prime croplands
27.12.2016 | Mercator Research Institute on Global Commons and Climate Change (MCC) gGmbH

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Water - as the underlying driver of the Earth’s carbon cycle

17.01.2017 | Earth Sciences

Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

17.01.2017 | Materials Sciences

Smart homes will “LISTEN” to your voice

17.01.2017 | Architecture and Construction

VideoLinks
B2B-VideoLinks
More VideoLinks >>>