Enhanced Medication Understanding
In an NIH funded trial, 200 Spanish-speaking Latino patients with diabetes at a primary care facility were randomized to receive either their standard written medication list or a visual-based PictureRx card. Patients in the intervention group had a better overall understanding of their medications (p<000.1), including greater ability to report the drug indication (p0.01), strength (p<0.05), dosing (p<0.01), and frequency of administration (p<0.001). 1
In a study with 100 at-risk older adults living in community housing, PictureRx significantly improved patients' confidence in taking medications correctly (p<0.001) For example, confidence in correctly taking several medications each day improved from 30% to 75%; confidence in taking medication more than once per day improved from 40% to 75% (could show this visually). 2
Patients who are given a PictureRx medication list at discharge are far more likely to be aderent with their doctor's instructions. In a randomized controlled trial of 435 patients with heart disease recruted from an urban, public hospital, PictureRx format instructions improved medicaiton refill adherence by 20% overall. The odds of adherence were doubled in high-risk groups including patients taking > 8 medicaitons, with less-than-average confidence about how to take their medications, and who had some non-adherence at baseline. 3
Reduced Medication Errors
PictureRx format instructions have been incorporated in hospital-based medication reconciliation and discharge counseling. In a large randomized medication reconciliation and discharge counseling. In a large randomized controlled trial funded by the NIH, an intervention that used PictureRx format instructions resulted in 31% reduction in potentially harmful medication errors after discharge from Vanderbilt University Hospital (p<0.05). 4
FOOTNOTES AND ADDITIONAL PUBLICATIONS
1) Kripalani S, Riley MB, Mohan A, Mashbum J, Davidson E, Boyington DR. Illustrated Instructions Improve medication understanding: a randomized controlled trial. Poster presentation at the 4th Health Literacy Annual Research Conference: Bethesda, MD, October 2012. Poster presentation at the 2012 Summit on the Science of Eliminating Health Disparities: National Harbor, MD, October 2012.
2) Martin D, Kripalani S, DuRapau VJ Jr. Improving medication management among at-risk older adults. J Gerontol Nurs 2012;38(6):24-34. (http://www.ncbi.nlm.nih.gov/pubmed/22587641)
3) Kripalani S., et al. Improving Medication Adherence through Graphically Enhanced Interventions in Coronary Artery Disease (IMAGE-CHD): A Randomized Controlled Trial. Journal of General Internal Medicine. 2012; 27(12):1609-1617.
4) Kripalani S., et al. Effect of Pharmacist Intervention on Clinically Important Medication Errors After Hospital Discharge: A Randomized Trial. Annals of Internal Medicine 2012; 157(1):1-10