P203: Evidence-based Design of Prescription Medication Information: An Updated Scoping Review
Poster Presenter
Andrea Russell
Assistant Professor
Northwestern University Feinberg School of Medicine United States
Objectives
The last literature review of patient medication information (PMI) comparison studies reviewed papers published up to 2015; thus we sought to provide an updated description of PMI comparison studies, details on patient involvement in PMI design, and consolidate evidence-based PMI design elements.
Method
Four databases (Ovid, Embase, CINAHL, and Cochrane) were searched for studies comparing 1+ types of PMIs (e.g. consumer medication information, medication guides). Eligible studies were: conducted in English-speaking countries, randomized controlled trials and published in 2016 or later.
Results
Thirty-two articles were included and most had some risk (n=24) or high risk of bias (n=4). Two-thirds of articles (n=21) reported on the details of PMI development, and over half (n=14) conducted formal pilot testing or obtained feedback from patients. Findings suggested positive outcomes when patients were involved in PMI development. Twelve studies examined written medication information (e.g., leaflets), 10 examined pharmacy-generated contained labelling (e.g., instructions printed on pill bottles), 2 examined supplemental information (e.g., medication regimen charts) and 14 examined PMI delivered using technology-support tools (e.g., text message instructions). The most prevalent assessed outcomes were knowledge (n=19), behaviors (n=17), attitudes/beliefs (n=11) and clinical outcomes, such as blood pressure (n=3). There was strong evidence for positive outcomes when PMI was designed according to health literacy principles of plain language, typographic cues, actionable instructions, large font and white space. Multiple trials of pictograms and illustrations alongside paired text and text messages to deliver PMI also had positive outcomes. Although there were several studies that examined interactive websites, audio and video delivery of PMI, mixed findings resulted in moderate evidence. Novel PMI design elements were introduced with limited evidence that require additional evaluation include content (i.e., a plain language label for as needed medications, inclusion of patient photos and quotes) and delivery (i.e., Quick Response codes, electronic health record-enabled strategies).
Conclusion
Overall, a high proportion of studies included patients in the development of PMI and focused on behavioral outcomes. However, clinical outcomes appear to be understudied. In addition to health literacy principles, this review demonstrated there is strong evidence for pictograms with paired text when used in written medication information and pharmacy generated labels. There is moderate evidence for using text messages to deliver PMI. Findings were inconsistent for PMI delivered via interactive websites, audio and video. Novel methods require additional study to determine best practices in design.
