Perceptions of prescription warning labels within an underserved population

Abstract

*Objective: To understand how underserved populations attend to prescription warning label (PWL) instructions, examine the importance of PWL instructions to participants and describe the challenges associated with interpreting the information on PWLs. Methods: Adults from an underserved population (racial and ethnic minorities, individuals with low income, older adults) who had a history of prescription medication use and were able to understand English took part in semistructured interviews. Participants were presented with eight different prescription bottles with an attached PWL. Participants were asked, "If this prescription was yours, what information would you need to know about the medicine?" The number of participants who attended to the warning labels was noted. Other questions assessed the importance of PWLs, the challenges with understanding PWLs, and ways a pharmacist could help participant understanding of the PWL. Results: There were 103 participants. The mean age was 50.25 years (SD=18.05). Majority attended to the PWL. Participants not currently taking medications and who had limited health literacy were likely to overlook the warning labels. Majority rated the warning instructions to be extremely important (n=86, 83.5 %), wanted the pharmacist to help them understand PWLs by counseling them on the information on the label (n=63, 61.2%), and thought the graphics made the label information easy to understand. Conclusions: PWLs are an important method of communicating medication information, as long as they are easily comprehensible to patients. In addition to placing PWLs on prescription bottles, health care providers need to counsel underserved populations on medication warnings, especially individuals with limited health literacy who are not currently using a prescription medication.

Inattentiveness to Warnings and Precautions on Prescription Drug Labels among Malaysian Adult Patients: The Influence of Polypharmacy

“…Different from previous studies which focused predominantly on auxiliary labels, [1][2][3]9] this study investigated the patients' attentiveness to warnings and precautions which were presented, along with their particulars and dosing instructions, on the same drug label. The findings confirm that approximately 80% of patients receiving medications from public hospitals in Malaysia did not pay attention to such information.…”

“…[1][2][3]11] Nonetheless, it is difficult to assess health literacy of all patients during the clinical encounter, especially in a busy health setting. [12] Rather, this study found a positive relationship between polypharmacy and patients' attentiveness to warnings and precautions on labels, with all the possible confounders, including age, ethnicity and employment status, adjusted.…”

“…[1] Yet, most patients, in particular those with low health literacy, did not pay attention to the auxiliary labels. [2,3] Therefore, in Malaysia, a number of public hospitals have been using the e-Hospital Information System (e-HIS) to assist in dispensing medications, with all drug-related information, including warnings and precautions, printed on a same label.…”

Pharmacists' perceptions and communication of risk for alertness impairing medications

“…Perceptions of consumers ignoring warning labels is consistent with published literature related to Australian consumers 23 and globally. 24,25 To counter this, several studies have tested ways to enhance the noticeability of warning labels through depicting organ specific damage, 26 black-box warnings and the addition of text and colour 13 . One study comparing warning labels used in Australia and France concluded that participants were more readily able to delineate risk levels from the French labelling system due to the inclusion of medication risk categorisation and the effective use of colour and graphics.…”

Supporting Older Adults with Mild Cognitive Impairment in Medication Taking: A 2-year Longitudinal Study

“…When individuals read the drug labels, we can easily find instructions like: 'take on an empty stomach', 'take 1 pill every 12 hours by mouth with a meal', 'do not chew or crush', 'swallow whole', 'take with food, 'avoid prolonged or excessive exposure to direct and/or artificial sunlight while taking this medication' or 'medication should be taken with plenty of water'. A significant percentage of older adults failed to understand these instructions [10,11]. For those who suffer from mild cognitive impairment (MCI), they may find these instructions less understandable.…”