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Medication Label Errors
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Many patients, regardless of their literacy level, are unable to interpret simple instructions on prescription medicine labels. A new study published in the Annals of Internal Medicine reports that while most patients can read the wording on the labels, surprisingly few know how and when to take the medicine, leading to potentially harmful effects.
According to a 2006 report from the Institute of Medicine, there are an estimated 1.5 million people in the United States who are injured by preventable drug errors each year. The treatment of drug-related injuries costs the country at least $3.5 billion annually.
To assess how errors in understanding prescription medicine labels contribute to this problem, researchers from Northwestern University and Louisiana State University recruited 395 mostly low-income English-speaking adults, who were waiting to see their doctors. They were shown prescription labels for 5 commonly used medicines, including those to lower blood pressure, reduce cough and an antibiotic. After reading the labels, participants were asked how they would take them, and were also evaluated on their understanding of additional instruction such as “take with food”, or “take two tablets by mouth twice daily.” The volunteers then underwent a standard 66-word literacy test to measure their reading levels.
They found that patients understood the labels less than half of the time, and that those with low literacy levels had significant difficulty understanding the instructions. Furthermore, while 71% of patients with low literacy correctly stated the instructions “take two tablets by mouth twice daily”, only 35% could demonstrate how many pills to take each day.
The researchers say that the inability to count accurately is an integral part of literacy, as demonstrated in the study findings. A contributing factor, may be awkward or unclear wording on the label, and the speed with which patients may read labels, perceiving them to be simple. The researchers also found that patients with multiple medications were more likely to misunderstand instructions.
They say it is clear that all patients would benefit if labels were easier to understand and comprehend, and they call for a redesign and standardization of prescription labels to include simpler and less ambiguous instructions.
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