Effects of Pictograms on How to Take Oral Tablets in illiterate Thai Muslim Patients
Article Sidebar
Main Article Content
Abstract
Objective: To evaluate understanding of pictograms on how to take oral tablets among illiterate Thai Muslim patients and to study their effects on medication compliance, recall of instruction for use and satisfaction towards drug labels of such patients. Method: The study consisted of two parts. The first focused on the evaluation of understanding of the pictograms in 126 illiterate Muslim patients. The tested pictograms reflected 10 most frequent instructions on how to take oral tablets found in Su-ngaipadi hospital. Pictograms in the study were developed by Bovornrat Angsuwattanakul and Sanguan Lerkiatbundit. The researchers showed 4 randomly selected pictograms to each subject, and interviewed his/her understanding of the pictograms. The subjects in second part of the study were illiterate Muslim patients to whom physicians prescribed new item(s) of drug. The subjects were randomly allocated into control group (n=61) with traditional labels and experimental group (n=61) with both traditional and pictogram labels for their new drug item(s). At the patients’ subsequent visit, the researchers assessed their medication compliance, recall of instruction on drug use and satisfaction towards labels. Medication compliance was assessed by pill counting. Recall and satisfaction were evaluated by interviewing the subjects. Results: In the first part of the study, more than 93.9% of the subjects correctly interpreted 10 pictograms in all aspects including number of tablets to be taken, frequency, number of times per day for drug taking and times relative to meals (before or after meals), satisfying the American National Standard Institute (ANSI) criteria for comprehensibility. The results of second part of the study showed that experimental group had a significantly higher level of compliance, recall on drug instruction and satisfaction towards received labels compared to those of control group. Conclusion: Health care institutions could apply the pictograms developed by Bovornrat Angsuwattanakul and Sanguan Lerkiatbundit to their illiterate Muslim patients. The pictorial labels are comprehensible by this group of patients and able to increase medication compliance, recall of instructions and patient satisfaction towards pictograms.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
2. National Statistics Office. Summary of main results from the survey of reading skill of the population in 2015 [online]. 2015 [cited Dec 8, 2016]. Available from: service.nso.go.th/nso/nsopublish/themes/files /readingPocket58.pdf
3. Ngoh LN, Shephred MD. Design, development, and evaluation of visual aids for communicating prescription drug instructions to non-illiterate patients in rural Cameroon. Patient Educ Couns 1997; 30: 245-61.
4. Houts PS, Doak, CC, Doak LG, Loscalzo MJ. The role of pictures in improving health communication: a review of research on attention, comprehension, recall, and adherence. Patient Educ Couns 2006; 61: 173-90
5. Katz MG, Kripalani S, Weiss BD. Use of pictorial aid
s in medication instructions: a review of the literature. Am J Health-Syst Pharm 2006; 63: 2391 -7.
6. Mansoor LE, Dowse R. Effective of pictograms on r
eadability of patient information materials. Ann Pharmacother 2003; 37: 1003-9.
7. Mansoor LE, Dowse R. Design and evaluation of a new pharmaceutical pictogram sequence to convey medicine usage. Journal of the Ergonomics Society of South Africa 2004; 2:29-41.
8. United States Pharmacopeial Convention. USP pictograms [online]. 2011 [cited Dec 6, 2015]. Available from: www.usp.org/usp-healthcare-profes sionals/related-topicsresources/usp-pictograms/ download-pictogram
9. Dowse R, Ehlers MS. The evaluation of pharmaceutical pictograms in a low-literate South African population. Patient Educ Couns 2001; 45: 87-99
10. Noiprom S, Srichatchawan S. Understanding of the USP DI pictograms among outpatients at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center, Nakhon Nayok Province. Thai Pharmaceutical and Health Science Journal 2005; 1: 270-1
11. Doak CC, Doak LG, Root JH. Teaching patients with low literacy skills. Philadelphia: J.B. Lippincott company; 1985.
12. Chaijinda K. Development and evaluation of pictorial labeling system for Northern Thai patients with low literate skills [dissertation]. Chiang Mai: Chiang Mai University; 2007.
13. Muangcharoen A. Development and evaluation of pharmaceutical pictograms in the Pga K'nyau, Sop Moei District, Mae Hong Son Province. [master thesis]. Chiang Mai: Chiang Mai University; 2008.
14. Phimarn W, Pianchana P, Rungsungnoen R, Ritthiya L, Pattaradunpituk W. Development and evaluation of pictorial labeling system for elderly patients with chronic disease. Isan Journal of Pharmaceutical Sciences 2014; 9(Supplement): 109-15.
15. Angsuwattanakul B, Lerkiatbundit S. Development of pictograms for illiterate patients part 1: instructions on how to take tablets. Thai Journal of Pharmacy Practice 2014; 6: 41-60.
16. American National Standard Institute. Accredited standard on safety colours, signs, symbols, labels, and tags, vol. Z535. Washington (DC): National Electrical Manufacturers Association, 1991.
17. Cochran WG. Sampling techniques. 3rd ed. New York: John Wiley & Sons; 1977
18. Bullinger M, Alonso J, Apolone G, Leplège A, Sullivan M, Wood-Dauphinee S, et al. Translating health status questionnaires and evaluating their quality: the IQOLA Project approach. J Clin Epidemiol 1998; 51: 913-23.
19. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39: 175-91.
20. Yadav S, Khatri S, Gehlaut R, Mishra N, Mittal P. Pharmaceutical pictogram in rationale use of drug and development of pharmaceutical care services: A mini review. International Journal of Research in Pharmaceutical and Biomedical Sciences. 2012; 3: 215-21.
21. Yin HS, Dreyer BP, Schaick LV, Foltin GL, Dinglas C, Mendelsohn AL. Randomized controlled trial of a pictogram-based intervention to reduce liquid medication dosing errors and improve adherence among caregivers of young children. Arch Pediatr Adolesc Med 2008; 162: 814-22.
