Pinoy Pharmacy

Picture courtesy of FDA

At this point, there is no clear national movement within the health care system to address this issue. However, there is increased awareness within the clinical community, and small changes by practitioners can be incorporated into daily practices to benefit patients now. Even with no further instruction, the prescription label should, at a minimum, be sufficiently clear to allow patients to take their medications properly. Thoughtful consideration of how to word medication directions, and use of clear and concise auxiliary labels, will go a long way towards helping patients take their medications properly.

Providing supplemental medication information for patients sounds like a useful way to expand their knowledge, right? Unfortunately, not only are these rarely provided to patients, 77% of patients report never having read them. Furthermore, average readability measures at the high school graduate level, which is significantly higher than the average reading ability. And even appropriately written medication information is unable to help patients when it is not provided, nor read by patients.

Patients also frequently misinterpret auxiliary labels. This “For External Use Only” warning label, which is frequently used and (we think) easily understood, elicited the following responses when patients were asked what it meant: “Use extreme caution in how you take it”; “Medicine will make you feel dizzy”; “Take only if you need it.” Furthermore, the colors chosen for auxiliary labels may be perceived by patients to have specific meaning, such as associating red with danger. Physicians and pharmacists should be aware that, while these labels are intended to provide useful information, they may require more explanation. In some instances they have been associated with patients performing actions in direct opposition to their intended message.

Another area of major concern is dosage frequency. Pharmacists need to consider this patient deficit as they generate new prescriptions to ensure the label is comprehensible to the patient. Physicians can help, too, by writing out explicit directions in layman’s terms instead of standard Latin sig codes, and using more numbers than words. For example, a label reading “Take 1 tablet every morning” would be less confusing than “Take one tablet once a day”. Medications taken twice a day create the greatest confusion for patients.

Pharmacists may be able to develop creative methods for labeling medication for individual patients with low literacy, such as placing two dots on a vial that needs to be taken twice a day and only one dot on a vial that is to be taken once day.

Another factor that can greatly influence a patient’s health literacy is the ability to speak and read English. Individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English have limited English proficiency (LEP). It is important to remember that patients with LEP who speak English well may have a difficult time reading English, and therefore are less able to interpret prescription label information

Filipinos read labels naman, kaso nga lang yung iba hindi talaga. They just rely on the advertisement set by the product owners. Paano ba natin sasabihin sa ating mga patient na kelangan nilang basahin ang label kasi isa ito sa mga importanteng bagay bago inomin ang gamot.