Development of Pictograms in Medication Labels for Elderly Patients with Chronic Diseases at Sena Hospital, Phra Nakhon Si Ayutthaya Province

Abstract

Objective: To develop pictograms for using in medication labels for elderly patients with chronic diseases, and test their comprehensibility. Method: The subjects were elderlies receiving oral chronic medications, being able to communicate in Thai, no hearing or sight disability and never receiving medication labels with pictograms. The study purposively selected the subjects for first and second rounds of pictogram development. Both rounds involved different subjects. The researcher collected drug use instructions and side effects of chronic medications, designed pictograms, and tested their comprehensibility in the subjects using the ANSI criteria (American National Standards Institute) that required symbols to have at least 85% correct understanding among subjects. Results: Comprehensibility test of 24 pictograms in the first round revealed that there were 9 pictograms satisfying the criteria including 3 times a day in morning-afternoon-evening, 4 times a day in morning-afternoon-evening-before bedtime, frequent urination, and pictograms for the number of tablets i.e., ¼, half, one and a half, two, two and a half, and 3 tablets. Therefore, the researchers conducted the second round of pictogram development by applying color in the symbols, and design universal symbols with local culture in them. Test of understanding of 11 pictograms in the second group of subjects showed that all met the ANSI criteria. Conclusion: The development of pictograms for using in medication labels should be based on knowledge, belief and local culture because it leads to an appropriate pictograms for target population.