Understanding of pictograms from the United States Pharmacopeia Dispensing Information (USP-DI) among elderly Brazilians

Izadora Mc Barros, Thaciana S Alcântara, Alessandra R Mesquita, Monica L Bispo, Chiara E Rocha, Vagner Porto Moreira, Divaldo P Lyra Junior, Izadora Mc Barros, Thaciana S Alcântara, Alessandra R Mesquita, Monica L Bispo, Chiara E Rocha, Vagner Porto Moreira, Divaldo P Lyra Junior

Abstract

Objective: To assess the understanding and cultural acceptability of the United States Pharmacopeia Dispensing Information (USP-DI) in a group of elderly Brazilians.

Methods: The study participants were individuals between 60 and 90 years old, of both sexes, with different levels of education and income. Fifteen of 81 pictograms from the USP-DI were presented to the elderly subjects, individually, without subtitles and in random order, so that the participants' understanding of the pictograms could be evaluated.

Results: The study included 116 participants. Only one of the selected pictograms reached the comprehension criterion established by the International Organization for Standardization 3864. With regard to the relationship between understanding and sociodemographic characteristics, age, wage income, and level of education were all found to be significantly associated with participants' understanding of some of the pictograms.

Conclusion: Most of the USP-DI pictograms evaluated were not well understood by the elderly Brazilians. This finding indicates that such pictograms need to be culturally adapted for the Brazilian context if they are to serve their purpose effectively in this country.

Keywords: Brazil; elderly; pictograms; understanding.

References

    1. Kessels RP. Patients’ memory for medical information. J R Soc Med. 2003;96(5):219–222.
    1. Liu CJ, Kemper S, McDowd J. The use of illustration to improve older adults’ comprehension of health-related information: is it helpful? Patient Educ Couns. 2009;76(2):283–288.
    1. Davis TC, Federman AD, Bass PF, 3rd, et al. Improving patient understanding of prescription drug label instructions. J Gen Intern Med. 2009;24(1):57–62.
    1. Galato F, Just MC, Galato D, Silva WB. Desenvolvimento e validação de pictogramas para o uso correto de medicamentos: descrição de um estudo-piloto [Development and validation of pictograms for the correct use of drugs: report of a pilot study] Acta Farm Bom. 2006;25(1):131–138. Portuguese.
    1. Sorfleet C, Vaillancourt R, Groves S, Dawson J. Design, development and evaluation of pictographic instructions for medications used during humanitarian missions. C Pharm J (Ott) 2009;142(2):82–88.
    1. Dowse R, Ehlers MS. The evaluation of pharmaceutical pictograms in a low-literate South African population. Patient Educ Couns. 2001;45(2):87–99.
    1. IBGE [homepage on the Internet] Synthesis of social indicators, an analysis of the conditions of life of the Brazilian population. Rio de Janeiro, Brazil: 2010. [Accessed September 30, 2014]. Available from: Portuguese.
    1. Ministry of Health, National Health Council - Brasilia Efetivando o SUS: Acesso, Qualidade e Humanização na atenção à Saúde, com Controle Social, 2000 – Relatório Final [Brazil speaking as want to be treated: effecting the NHS: access, quality and humanization in health care with social control.]; 11th National Conference on Health; December 15–19, 2000; Brazil. Ministry of Health. 2001. Portuguese.
    1. World Health Organization . The role of the pharmacist in the health care system, preparing the future pharmacist: curricular development. Vancouver: World Health Organization; 1997. Report of a third WHO consultative group on the role of the pharmacist.
    1. International Pharmaceutical Federation [webpage on the Internet] MEPS pictogram project. [Accessed September 20, 2013]. [updated May 23, 2013; cited August 10, 2013]. International Pharmaceutical Federation. Available from: .
    1. Dowse R, Ramela T, Browne SH. An illustrated leaflet containing antiretroviral information targeted for low-literate readers: development and evaluation. Patient Educ Couns. 2011;85(3):508–515.
    1. Vaillancourt R, Dawsn J, Pascuet E, Grenier S. International pictogram project for the labelling of medication. Can J Hosp Pharm. 2011;64(1):82–86.
    1. International Organization for Standardization . Graphical Symbols – Test Methods – Part 1: Methods for Testing Comprehensibility. Geneva, Switzerland: International Organization for Standardization; 2007. ISO 9186-1.
    1. International Organization for Standardization . International Standards for Safety Colours and Safety Signs. Geneva, Switzerland: International Organization for Standardization; 1984. ISO 3864.
    1. Hämeen-Anttila K, Kemppainen K, Enlund H, Bush Patricia J, Marja A. Do pictograms improve children’s understanding of medicine leaflet information? Patient Educ Couns. 2004;55(3):371–378.
    1. Kalsher MJ, Wogalter MS, Racicot BM. Pharmaceutical container labels: enhancing preference perceptions with alternative designs and pictorials. Int J Ind Ergon. 1996;18(1):83–90.
    1. Ngoh LN, Shepherd MD. Design, development, and evaluation of visual aids for communicating prescription drug instructions to non-literate patients in rural Cameroon. Patient Educ Couns. 1997;31(3):245–261.
    1. Katz MG, Kripalani S, Weiss BD. Use of pictorial aids in medication instructions: a review of the literature. Am J Health Syst Pharm. 2006;63(23):2391–2397.
    1. Kassam R, Vaillancourt R, Collins JB. Pictographic instructions for medications: do different cultures interpret them accurately? International Journal of Pharmacy Practice. 2004;12(4):199–209.
    1. Hanson EC, Hartzema A. Evaluating pictograms as an aid for counseling elderly and low-literate patients. J Pharm Mark Manage. 1995;9(3):41–54.
    1. Dowse R, Ehlers MS. The influence of education on the interpretation of pharmaceutical pictograms for communicating medicine instructions. International Journal of Pharmacy Practice. 2003;11(1):11–18.
    1. Davies S, Haines H, Norris B, Wilson JR. Safety pictograms: are they getting the message across? Appl Ergon. 1998;29(1):15–23.
    1. Mansoor LE, Dowse R. Effect of pictograms on readability of patient information materials. Ann Pharmacother. 2003;37(7–8):1003–1009.
    1. Knapp P, Raynor DK, Jebar AH, Price SJ. Interpretation of medication pictograms by adults in the UK. Ann Pharmacother. 2005;39(7–8):1227–1233.
    1. Sampaio LF, Lima da Silva LM, Velho GCC, Martins MGG, Castilho SR, Altenburg SP. Pictograms as a medical prescription language comprehension. Rev Bras Farm. 2008;89(2):150–154. Portuguese.
    1. Grenier S, Vaillancourt R, Pynn D, et al. Design and development of culture-specific pictograms for the labelling of medication for first nation communities. Journal of Communications in Healthcare. 2011;4(4):238–245.
    1. Goel G. A comparative study to evaluate patients interpretation of USP and locally designed pharmaceutical pictograms. Pharma Times. 2010;42(6):16–19.
    1. Mwingira B, Dowse R. Development of written information for anti-retroviral therapy: comprehension in a Tanzanian population. Pharm World Sci. 2007;29(3):173–182.
    1. Braich PS, Almeida DR, Hollands S, Coleman MT. Effects of pictograms in educating 3 distinct low-literacy populations on the use of postoperative cataract medication. Can J Ophthalmol. 2011;46(3):276–281.
    1. Download USP Pictograms [webpage on the internet] The United States Pharmacopeial Convention. 2014. [Accessed September 18, 2014]. Available from: .

Source: PubMed

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