Can Improved Prescription Medication Labeling Influence Adherence to Chronic Medications? An Evaluation of the Target Pharmacy Label

Abstract

BACKGROUND: Prescription medication labels contain valuable health information, and better labels may enhance patient adherence to chronic medications. A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve readability and understanding. OBJECTIVE:We evaluated whether the new Target label influenced patient medication adherence. DESIGN AND PATIENTS:Using claims from two large health plans, we identified patients with one of nine chronic diseases who filled prescriptions at Target pharmacies and a matched sample who filled prescriptions at other community pharmacies. MEASUREMENTS:We stratified our cohort into new and prevalent medication users and evaluated the impact of the Target label on medication adherence. We used linear regression and segmented linear regression to evaluate the new-user and prevalent-user analyses, respectively. RESULTS: Our sample included 23,745 Target users and 162,368 matched non-Target pharmacy users. We found no significant change in adherence between new users of medications at Target or other community pharmacies (p= 0.644) after implementing the new label. In prevalent users, we found a 0.0069 percent reduction in level of adherence (95% CI −0.0138-0.0; p< 0.001) and a 0.0007 percent increase in the slope in Target users (the monthly rate of change of adherence) after implementation of the new label (95% CI 0.0001-0.0013; p=0.001). CONCLUSIONS:We found no changes in adherence of chronic medication in new users, and small and likely clinically unimportant changes in prevalent users after implementation of the new label. While adherence may not be improved with better labeling, evaluation of the effect of labeling on safety and adverse effects is needed.

Design and test of preference for a new prescription medication label

“…Recently, two articles have been published on the impact of better labeling (Target ClearRx Ò labels) on adherence and rate of outpatient and inpatient health services use and emergency room visits. Although both studies had limitations such as exclusion of elderly, uninsured and beneficiaries of Medicaid in their sample study, overall, neither study demonstrated a significant impact of labels on adherence or outcomes [28,29]. Other studies including vulnerable groups of patients and differing levels of health literacy should be performed to confirm these results.…”

“…Also, determining preference may not necessarily correspond to usefulness in practice but it provides an indirect examination of usefulness because if the stakeholders prefer a label, it is more likely to be useful to them. We would like to restate the caveat, that while there may be evidence that misunderstanding labels could lead to poor patient outcomes, there is no current evidence that improving labels will lead to better outcomes [9,28,29]. Given that California is poised to move to a standardized, user-friendly label, the extension of the current research appears imperative.…”

A Patient-Centered Prescription Drug Label to Promote Appropriate Medication Use and Adherence

“…An earlier evaluation of changes to a prescription drug container and labeling did not find benefits to adherence or health outcomes. 32,33 While we cannot isolate the independent benefits of the various label changes made with the PCL, the UMS is one new, evidence-based labeling component not included in the prior mentioned research investigations. To the best of our knowledge, this is only the second investigation to evaluate explicit changes to a prescription drug container label in actual use, and the first to include the UMS.…”

A Randomized Telephone Intervention Trial to Reduce Primary Medication Nonadherence

“…[1][2][3] Extensive evaluation of the rates [4][5][6] and predictors [7][8][9][10][11][12] of nonadherence have been conducted, and numerous interventions have been implemented to improve the way patients take their medications. [13][14][15] However, an important component of taking medication has been largely overlooked until the past several years.…”