“Even though the USP guidelines are out there, they haven’t really taken off because what we learned is that pharmacies don’t know how to make these changes,” says Mott.īefore they jumped into redesigning the label, they wanted to speak with various stakeholders - pharmacists, physicians, software vendors - to assess and account for the barriers. So if they found value in the standards, why had they not been implemented yet? UW Health’s prescription medication labels, before and after a redesign in cooperation with Wisconsin Health Literacy that prioritizes and clarifies information patients need.
In another survey of Wisconsin pharmacists by WHL, 85 percent of respondents supported a general adoption of the standards. Instead of saying “take twice daily,” which leaves a lot of ambiguity - two at once? 12 hours apart? - the labels should say “take 1 pill in the morning and 1 pill in the evening,” for example.
The USP guidelines address a lot of that feedback by suggesting simplified language, in the patient’s preferred language when possible improved readability through using increased whitespace, contrast, and sentence case and giving explicit instructions, among other standards. “Because they aren’t looking, they don’t know how to take their medications, and then a lot of times they just end up not taking it at all.” Prescription labels are intended to give patients the information they need to appropriately take their medication at home - yet until USP released their guidelines, they did not have a patient-centric design.ĭuring early focus groups with the public, “we frequently heard that there is just too much on the label for patients to understand, so they don’t even bother to look,” says Mott. The project, now in its third phase, has been in progress since 2014 and has already improved patient metrics. So far 20 pharmacies have joined to redesign their labels, including Ballweg Family Pharmacy and major health system pharmacies like UW Health, Aurora, Froedtert, GHC-SCW, Mercyhealth, and Ascension.
“We want to get as many pharmacy partners as possible to modify their labels using our toolkit or implementation guide,” says Mott. Their work earned a 2018 Pearl Award from the North American Primary Care Research Group and was selected as one of the top three out of 1,300 submissions. “We frequently heard that there is just too much on the label for patients to understand, so they don’t even bother to look.” –David Mottīut a project led by Wisconsin Health Literacy with a range of collaborators, including University of Wisconsin–Madison School of Pharmacy Professor David Mott, is paving the way to get all Wisconsin pharmacies on board by creating a framework for implementation, which can help out-of-state pharmacies improve their labels, too. To date, Utah is the only state to have formally adopted the standards. The United States Pharmacopeia (USP) in 2013 released a set of standards for patient-centered prescription medication labels, General Chapter 17 in USP’s formulary, which focus on readability and clarity. “As pharmacists, it’s easy to get so used to looking at our labels that we can forget they can be difficult for patients to understand, and the differences between pharmacies can further disorient patients,” says Sandberg. A recent survey of state residents by Wisconsin Health Literacy (WHL), a division of Wisconsin Literacy, Inc., found that 88 percent of respondents found current medication labels confusing, and 23 percent reported having taken a medication incorrectly because of confusing labeling. Research shows that this experience is not uncommon, and patients themselves think it’s time for a change. the patient had a prescription for a medication to help quiet that disruptive feeling, but on the label - which read “take two tablets by mouth two to three hours before bed” - all they could see was the number “three.” The patient continually took three tablets.Īfter speaking with the patient and physician, Nicole Sandberg, a pharmacist at Ballweg Family Pharmacy, decided to rewrite her prescription label to make it clearer for the patient to understand: “Take two tablets by mouth two hours before bed.” With only one number present, the label was easier for the patient to digest, and she was able to manage her medications more easily. Project with faculty participation has Wisconsin pharmacies re-thinking prescription labelsĪn older patient, who was beginning to experience dementia, also had perpetually restless legs, which would keep them from being able to fall asleep at night.
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