Back to Journals » Patient Preference and Adherence » Volume 12

The evaluation of pharmaceutical pictograms among elderly patients in community pharmacy settings – a multicenter pilot study

Authors Merks P, Świeczkowski D, Balcerzak M, Drelich E, Białoszewska K, Cwalina N, Krysinski J, Jaguszewski M, Pouliot A, Vaillancourt R

Received 27 August 2017

Accepted for publication 28 November 2017

Published 14 February 2018 Volume 2018:12 Pages 257—266


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Piotr Merks,1,2,* Damian Świeczkowski,3,* Marcin Balcerzak,4 Ewelina Drelich,4 Katarzyna Białoszewska,5 Natalia Cwalina,3 Jerzy Krysinski,1 Miłosz Jaguszewski,3 Annie Pouliot,6 Regis Vaillancourt6

1Department of Pharmaceutical Technology, Collegium Medicum in Bydgoszcz, Nicolaus University in Torun, Bydgoszcz-Torun, Poland; 2Piktorex Sp. z.o.o., Warsaw, Poland; 3First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland; 4Farenta Polska, Warsaw, Poland; 5Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland; 6Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

*These authors contributed equally to this work

Introduction: The search for new ways to optimize the use of medications by patients has led the pharmaceutical community to promote the idea of introducing pictograms into routine practice. The main intention of pictograms is to ease patient adherence and to reduce potential risks or errors associated with the use of medications.
To evaluate a series of pharmaceutical pictograms for patient comprehension.
Patients and methods: The study was conducted in community pharmacies within a European Union country that belongs to the professional research network. Structured interviews were used to evaluate the pictograms for patient comprehension. This consisted of an assessment of the following: the transparency and translucency of the pictograms, health literacy, and pictogram recall. Participants were also given the opportunity to provide feedback on how to improve the pictograms. The primary endpoint was pictogram comprehension. Secondary outcomes included recall of the pictograms and pictogram translucency.
Results: The study included 68 patients with whom face-to-face interviews were performed. Low transparency results (≤25%) and extensive patient feedback in initial interviews led to the withdrawal of certain pictograms (n=15) from the evaluation. Among the pictograms included in the final stage of our research, 22 pictograms (62.8%) obtained an acceptable transparency level ≥66%. All pictograms passed the short-term recall test with positive results.
Conclusion: A majority of the designed and modified pictograms reached satisfactory guessability scores. Feedback from patients enabled modification of the pictograms and proved that patients have an important voice in the discussion regarding the design of additional pictograms.

Keywords: pharmaceutical pictograms, elderly population, health literacy, community pharmacy, Poland

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]