Duke-NUS aims to simplify medication instructions through pictograms

Health institutions were encouraged to adopt this.

Researchers from Duke-NUS Medical School have developed 35 pictograms that can be added to prescription medication packets and bottles to better explain to patients, especially senior citizens, the proper way to take their medications. 

Citing a 2020 study, Duke–NUS said that half of 1,167 older adults had trouble understanding medication labels. This often led to incorrect dosages and missed doses, resulting in not taking medication as prescribed.

To address these issues, the researchers and their collaborators from SingHealth Polyclinics; two healthcare institutions of the National Healthcare Group (NHG) – National Healthcare Group Polyclinics (NHGP) and NHG Pharmacy (NHGPh); and the National Institute of Education, curated and tested a set of 35 pictograms.

Twenty of them were developed by the International Pharmaceutical Federation Foundation for Education and Research. The Duke-NUS researchers and their collaborators supplemented these with 15 pictograms that were developed specially for Singapore’s context and culture.

As part of the “Prescription Medication Label Improvement for Singaporean Elderly” project, pictograms were evaluated in two studies conducted between March 2019 and February 2021. Over 600 older Singaporean adults aged 60 and above participated, including those with limited or no English proficiency.

The researchers found that all the pictograms were found to be valid for use without the need for further testing or modification, with more than 66% of study participants interpreting them correctly and more than 85% rating the pictograms as representing their intended meanings well.

The developers are now working with public healthcare institutions and pharmacies for the rollout of the pictograms. 

“Older patients rely heavily on medication labels as a source of information due to higher prevalence of chronic diseases and medication intake. There is an urgent need to improve existing medication labels to help older adults take their medication safely and better adhere to their medication routine,” said Rahul Malhotra, deputy director of Duke-NUS Centre for Ageing Research and Education (CARE), who supervised the studies as the principal investigator of the PROMISE project.