Piotr Merks, Justyna Kazmierczak, Katarzyna Białoszewska, Karolina Binek, Aleksandra Olszewska, Regis Vaillancourt, Jerzy Krysinski

Stosowanie piktogramów jako pierwszy krok we wprowadzaniu etykietowania aptecznego w Polsce – badanie pilotażowe
2015-03-10

The use of pictograms as the first step in introducing pharmacy labelling in Poland – pilot study

Background

Poland has not yet developed a labelling strategy that would ensure safe and effective use of medicines by patients. According to our previous study, 50% of Polish patients preferred to receive information in a written format following their consultation(s) with a doctor. The study also showed that 62% of UK patients were very satisfied with the fact that their medicines were labelled. The lack of clear, easily understandable information about the use of medicines, lack of clearly formulated precautionary warnings and lack of storage instructions attached to the medicinal product package may cause potential drug related problems. Labelling of medicine packages in pharmacies is regulated in the UK. Labels used in the dispensing process in the UK provide a concise summary of all essential information about medicines that patients need to use them safely and effectively. This pilot study was the first trial to introduce the concept of medication labelling in Poland, based on the UK standards. The objectives of this pilot study were to investigate the opinions of Polish patients about the usefulness of cautionary and advisory pictogram labels placed on medicine boxes in a community pharmacy setting.

Material and methods

The study involved 33 people (age range between 22 and 80 years (average age 44 years), of which 67% (n=22) were female and 33% (n=11) were male). A total of 8940 pictogram labels with selected warnings and directions were affixed to medicinal product packages of prescription medicines and OTC (over the counter) medicines purchased by patients between 3rd of September 2012 and 31st of March 2013. After this period a two part, anonymous questionnaire was distributed to pharmacy-visiting patients in the town of Radzymin (10207 citizens; in the Mazovia Region of Poland). The first part of the questionnaire collected general information from patients whose medicines were labelled. The second part of the questionnaire was conducted two weeks later. Patients were telephoned and asked questions about pictograms labels. All participants had individual numbers assigned to them for the purpose of identification. All statistical analyses were performed using Statistica 10. Ethical approval was not required for this study.

Results

The majority of comments were positive with regards to medication labels. Thirty three percent (33%, n = 11) of respondents suffered from a chronic disease. Twenty one percent (21%; n = 7) declared taking 2–3 different medicines, and one respondent (3%; n = 1) – 4 to 5 different medicines. Twenty one percent (21%; n = 7) of respondents stated that they did not receive any written instructions from their doctor. Fifty two percent (52%, n = 17) declared that they had lost paper cards that contained instructions printed by their doctor. It was found that patients under the age of 45 years lost their cards containing medical advice more often (p = 0.014), and forgot to take their medicines more often than the group of patients older than 45 years. Forty one percent (41%, n = 14) of respondents stated that they knew they tend to forget to take their medicines, and thirty three percent (33%, n = 11) knew they tend to sometimes forget the administration instructions. The study showed that more women than men forgot doctors’ instructions (p = 0.07). In addition, sixty one percent (61%, n = 20) of respondents were not informed by a pharmacist on how to use the medication and an equal number of patients read the Patient Information Leaflet (PIL) supplied with the medicine. Seventy nine percent (79%, n = 26) of respondents stated that the use of pharmacy pictogram labels definitely helped them with the use of prescribed medicines and eighty five percent (85%, n = 28) stated that pictograms improved their compliance. Seventy three percent (73%, n = 24) of respondents stated that the pictogram labels should be affixed to all medicines, and eighty five percent (85%, n = 28) stated that the pictograms should be included in the pharmacy dispensing service, while sixty three percent (63%, n = 21) stated medicines should only be labeled upon request. Participants under 45 years of age considered labels to be more beneficial than the over 45 year old group. In overall, a vast majority of respondents considered pictogram labels to be very useful.

Conclusions

Pictogram labels were considered useful by participants of the study. Pictogram labels that provide essential but simple information and warnings about medication are components of pharmaceutical care. The study showed that patients very often do not receive any information about medication from doctors nor pharmacists. Medicine labeling should be introduced in Poland.

Keywords: Pictograms, labelling, pharmaceutical care, compliance, non‑adherence, pharmacotherapy.

© Farm Pol, 2015, 71(2): 70-80