Understanding Medication Schedules: Do Pictograms Help?

BACKGROUND: Previous studies suggest that pictograms may improve patients' understanding of medication schedules. Understanding a medication schedule is a necessary first step for medication adherence. OBJECTIVE: This study aimed to determine if pictograms improved patients' ability to correctly fill a pillbox. DESIGN: This is a randomized, controlled, crossover pilot study. PARTICIPANTS: This study involves 30 patients on the medical wards of an urban, tertiary care center. MAIN MEASURES: The PillBox Test required participants to fill a 7-day pillbox with pill-sized colored beads. Participants were randomized to either the control or the experimental condition first. In the control condition, a standard pillbox was used with text instructions on the pill bottles. In the experimental condition, a pictogram pillbox was used with text and pictogram instructions on the pill bottles. KEY RESULTS: There was no significant difference in passing on text or pictogram PillBox Test based on the order of group administration. However, 77% of participants reported that pictograms helped them understand medication instructions, 67% of participants preferred pictograms, and 93% felt pictograms should be used on all medication labels. CONCLUSIONS: In this pilot study, the use of pictograms did not significantly improve participants' ability to correctly fill a pillbox. However, most participants preferred pictograms to text labels. Further research is needed to determine the efficacy of pictograms in specific populations.