Patients’ ability to read and understand dosing instructions of their own medicines – a cross sectional study in a hospital and community pharmacy setting

Abstract

BackgroundPoor communication of medicines information to patients may cause medication errors. We assessed the completeness and readability of dosing instructions provided by pharmacists on dispensing labels and knowledge among patients on dosing instructions of their medicines.MethodsA cross sectional study was conducted in a selected teaching hospital, and a community pharmacy, among 800 patients selected through a systematic sampling method, during a period of 2 months. Completeness of dosing instructions were assessed against a checklist. Patients were asked to read dosing instructions to assess readability. Patient knowledge on dosing instructions were determined through a questionnaire. Completeness, readability and knowledge were scored out of 10 for each dispensing label.ResultsA total of 1200 and 1372 dispensing labels were assessed in the hospital and community settings respectively. The median score out of 10, for completeness, readability and patient knowledge of dosing instructions were 6.7, 8.3 and 7.5 respectively in the hospital, and 7.5, 8.0 and 7.5 respectively in the community. Only a few dispensing labels had the route of administration (hospital, 0.5%; community, 0.8%) and the duration of treatment written (hospital, 0.25%; community, 0.65%) on them. Name (hospital, 48%; community, 27.3%) and strength (hospital, 40.2%; community, 36.6%) of medicines on dispensing labels were frequently misread. In both settings, readability scores significantly differed with education level (P < 0.001).ConclusionsSome important dosing instructions were missing in dispensing labels. Readability of dosing instructions by patients was also not 100% and differed by their education level. Pharmacists did not adhere to a standard procedure in providing dosing instructions leading to communication gaps with patients. Hence we recommend the development of a standard procedure to provide complete, clear and simple dosing instructions to patients, and continuous training for pharmacists on proper communication of dosing instructions to patients.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3252-1) contains supplementary material, which is available to authorized users.

Pharmacists’ Perception on Dosing Instructions for Medicines - A Cross Sectional Study in a Hospital and Community Pharmacy Setting

“…In another study conducted by us in the same study settings, it was found that dosing instructions were not 100% complete, and patients were not able to completely read or understand dosing instructions provided. (7) This finding too reconfirms the serious gap in the communication process as highlighted by pharmacists. (7) When considering verbal instructions, linguistically accessible medication instructions are particularly important to ensure patient safety.…”

“…(7) This finding too reconfirms the serious gap in the communication process as highlighted by pharmacists. (7) When considering verbal instructions, linguistically accessible medication instructions are particularly important to ensure patient safety. In an American study, it was found that more than 80% of the pharmacies surveyed, lacked systematic methods for identifying linguistic needs of patients and the need for translation.…”

“…(6) There is evidence that essential dosing instructions are frequently missed by pharmacists which is a concern of patient safety. (7) It is important that pharmacists are provided with the right environment and facilities to effectively disseminate medicine related information to patients. It is also important to assess the level of importance pharmacists attribute to providing dosing instructions in a suitable mode before this task is entrusted upon them.…”

Assessing Individual Medication Adherence among Chronic Kidney Disease Patients: A Multi-centered Study

“…Medication knowledge was assessed for each medication taken using an assessment of drug dose (D), frequency (F), indication (I), and administration (T) (DFIT) [19,20]. Medications knowledge was measured based on the number of correct responses as a correct answer was scored as '1', whilst an incorrect answer was scored '0' [19,20]. The total score for each medication was calculated based on the number of correct answers; [number of correct answers/4] x100% [19,20].…”

“…Medications knowledge was measured based on the number of correct responses as a correct answer was scored as '1', whilst an incorrect answer was scored '0' [19,20]. The total score for each medication was calculated based on the number of correct answers; [number of correct answers/4] x100% [19,20]. An overall knowledge score was determined by determining the average score of all medications.…”