Kripalani Sunil, Robertson Rashanda, Love-Ghaffari Melissa H, Henderson Laura E, Praska Jessica, Strawder Akilah, Katz Marra G, Jacobson Terry A
Division of General Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA.
Patient Educ Couns. 2007 Jun;66(3):368-77. doi: 10.1016/j.pec.2007.01.020. Epub 2007 Mar 6.
Patients with low health literacy have difficulty understanding prescription drug labels and other medication instructions. This article describes the development, implementation, and preliminary evaluation of an illustrated medication schedule (a "pill card") that depicts a patient's daily medication regimen using pill images and icons.
Participants in a randomized controlled trial who were assigned to receive the pill card intervention described their use of the card and its perceived effectiveness. Responses were analyzed by level of patient literacy and other characteristics.
Among the 209 respondents, 173 (83%) reported using the pill card when they initially received it, though use declined to 60% approximately 3 months later. Patients with inadequate or marginal literacy skills, less than high school education, or cognitive impairment were most likely to refer to the card on a regular basis initially and at 3 months (p<0.05). Most pill card users (92%) rated the tool as very easy to understand, and 94% found it helpful for remembering important medication information, such as the name, purpose, or time of administration.
Nearly all patients considered an illustrated medication schedule to be a useful and easily understood tool to assist with medication management. Patients with limited literacy skills, educational attainment, or cognitive function referred to the aid with greater frequency.
Picture-based instructions promote better understanding of prescription medications, particularly among patients with limited literacy skills or cognitive impairment, and should be used more widely in practice.
健康素养较低的患者在理解处方药标签和其他用药说明方面存在困难。本文描述了一种带插图的用药时间表（“药卡”）的开发、实施和初步评估，该药卡使用药丸图像和图标来描绘患者的每日用药方案。
一项随机对照试验中的参与者被分配接受药卡干预，他们描述了药卡的使用情况及其感知到的有效性。根据患者的识字水平和其他特征对回答进行分析。
在209名受访者中，173人（83%）报告在最初收到药卡时使用了该药卡，不过大约3个月后使用率降至60%。识字技能不足或一般、高中以下学历或有认知障碍的患者最有可能在最初和3个月时经常参考该药卡（p<0.05）。大多数药卡使用者（92%）将该工具评为非常易于理解，94%的人认为它有助于记住重要的用药信息，如名称、用途或服用时间。
几乎所有患者都认为带插图的用药时间表是一种有用且易于理解的辅助用药管理的工具。识字技能、教育程度或认知功能有限的患者更频繁地参考这一辅助工具。
基于图片的说明能促进对处方药的更好理解，尤其是在识字技能有限或有认知障碍的患者中，应在实践中更广泛地使用。
