Patients’ Perspective And Usefulness Of Pictograms In Short-Term Antibiotic Therapy – Multicenter, Randomized Trial
Received 4 May 2019
Accepted for publication 14 August 2019
Published 2 October 2019 Volume 2019:13 Pages 1667—1676
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Justinn Cochran
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Piotr Merks,1,2,* Damian Świeczkowski,3,* Marcin Balcerzak,4 Ewelina Drelich,2,4 Katarzyna Białoszewska,5 Natalia Cwalina,3 Szymon Zdanowski,3 Jerzy Krysiński,6 Grażyna Gromadzka,1 Miłosz Jaguszewski3
1Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland; 2Piktorex sp. z o.o., Warsaw, Poland; 3First Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland; 4Farenta Polska sp. z o.o., Warsaw, Poland; 5Department of Paediatric Dentistry, Medical University of Warsaw, Warsaw, Poland; 6Department of Pharmaceutical Technology, Faculty of Pharmacy, Nicolaus University in Toruń, Toruń, Poland
*These authors contributed equally to this work
Correspondence: Piotr Merks
Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Wóycickiego 1/3, 01-938, Warsaw, Poland
Tel +48 22 602 101 979
Purpose: To evaluate the practical utility of pharmaceutical pictograms in routine practice in community pharmacy. The primary outcome (composite endpoint) consisted of three elements: i) complete use of the whole package of medication, ii) taking the recommended dose twice a day, and iii) subjective assessment of patients’ perspective on medical information about antibiotic therapy obtained during the pharmacy consultation measured by Net Promoter Score in scale from 1 to 10 where 1 is the lowest and 10 the highest possible rating.
Patients and methods: A multicenter, randomized controlled study was conducted. Community pharmacies (n = 64) which agreed to participate in the study were assigned to one of two groups: i) study – providing an antibiotic with pictograms placed on the external packaging of the medicinal product containing information about drug regimen (n = 32); or ii) control – providing an antibiotic according to usual pharmacy practice (n = 32). Two semi-structured interviews were performed. Data were collected from 199 patients with a mean age ± SD of 45.5 ± 17.0 years.
Results: In the control group, 15.7% of participants discontinued therapy before using the whole package compared with 13.4% of participants in the study group. In the control group, 81.3% of patients reported that they always took the medication twice a day as recommended by their healthcare providers compared with 80.4% of patients in the study group. The Net Promoter Score was higher for pharmacy practice with than without pictograms (71.3% vs 51.5%, respectively, p<0.005). The chance that a patient was an advocate of pharmaceutical services (scores 9 and 10) was twice as likely in the case of pharmaceutical practice supported by pictograms (p<0.02). The composite endpoint was achieved more frequently in the population using pictograms, however this difference was not statistically significant (p<0.34).
Conclusion: The pharmaceutical pictograms are readily accepted by patients and could prove to be a valuable support for pharmacists in conducting pharmaceutical care. Further representative research is needed to evaluate the true effectiveness of this solution.
Keywords: antibiotic therapy, adherence to treatment, pictograms, pharmaceutical care, satisfaction, patient perspective, pharmacist
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