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M 11: Best Practices for the Design and Dissemination of Patient Medication Information: A Systematic Review
Clinical Psychology Student, Health Literacy and Learning program
Northwestern University United States
Our objective is to present findings from a recent, systematic review of evidence supporting best practices for the presentation of quantitative, qualitative and descriptive information pertaining to the use and precautions associated with prescribed medications.
Articles were selected from three online databases (PubMed, EMBASE, CINAHL) and screened by three independent coders. Manuscripts were eligible if they were 1) English-language, 2) conducted in the US, UK or Australia and 2) provided evidence on how to improve prescription drug labeling practices.
A total of 14,285 articles were returned from the primary search. Following the title review, 190 articles remained. The abstract review eliminated an additional 94 articles. After reviewing the 96 remaining articles, 67were selected for data abstraction. Review of the selected articles revealed various themes related to best practices for 1) health literacy and the use of plain language, 2) labeling format and organization, 3) numerical content for representation of empirical results, 4) use of pictograms and illustrations, 5) shared decision making, and 6) modes of dissemination. Common outcomes of interest included satisfaction, knowledge and comprehension, retention of information, patient preference, and behavior (i.e. adherence, medication errors). To the latter, outcomes related to demonstrated or actual use of prescribed medications were less prevalent. A quality rating review revealed the majority of studies were labeled less than ‘good’ in terms of methodological quality, with less than half utilizing a randomized controlled design. Very few studies engaged patients’ perspectives in the design of these educational materials, or at least provided minimal detail on how patient involvement was operationalized.
The present body of literature demonstrating evidence of best practices for medication communication is surprisingly limited, either in terms of breadth of research and definitive findings, or methodological rigor. The evidence is strongest in terms of using plain language and patient-friendly content to convey risks and benefits to patients, including the use of explicit, while parsimonious text. Evidence was also moderately strong for format and organization of written labeling materials, while less so for other multimedia options. However, findings here were variable and not cohesive. Studies examining quantitative information presentation formats were prominent but suffered from methodological weaknesses, including less generalizable samples. Beyond a call to action for more definitive studies to inform practice standards for industry and others on how to best communicate medication information to consumers, we review a sizable evidence base and share thoughts on what can be solidified for recommendations now, and how to narrow future research objectives to best fill needed gaps. Importantly, future studies should also consider engaging patients earlier in the design process to optimize comprehensibility and use of patient medication information.