Shrank William H, Agnew-Blais Jessica, Choudhry Niteesh K, Wolf Michael S, Kesselheim Aaron S, Avorn Jerry, Shekelle Paul
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Ste 3030, Boston, MA 02120, USA.
Arch Intern Med. 2007 Sep 10;167(16):1760-5. doi: 10.1001/archinte.167.16.1760.
Medication errors occur frequently, and poor medication labeling is cited as a potential cause. We assessed the format, content, and variability of prescription drug container labels dispensed in the community.
Identically written prescriptions for 4 commonly used medications (atorvastatin calcium [Lipitor], alendronate sodium [Fosamax], trimethoprim-sulfamethoxazole [Bactrim], and ibuprofen) were filled in 6 pharmacies (the 2 largest chains, 2 grocery stores, and 2 independent pharmacies) in 4 cities (Boston, Chicago, Los Angeles, and Austin [Texas]). Characteristics of the format and content of the main container label and auxiliary stickers were evaluated. Labels were coded independently by 2 abstractors, and differences were reconciled by consensus.
We evaluated 85 labels after excluding 11 ibuprofen prescriptions that were filled with over-the-counter containers that lacked labels printed at the pharmacy. The pharmacy name or logo was the most prominent item on 71 (84%) of the labels, with a mean font size of 13.6 point. Font sizes were smaller for medication instructions (9.3 point), medication name (8.9 point), and warning and instruction stickers (6.5 point). Color, boldfacing, and highlighting were most often used to identify the pharmacy and items most useful to pharmacists. While the content of the main label was generally consistent, there was substantial variability in the content of instruction and warning stickers from different pharmacies, and independent pharmacies were less likely to use such stickers (P < .001). None of the ibuprofen containers were delivered with Food and Drug Administration-approved medication guides, as required by law.
The format of most container labels emphasizes pharmacy characteristics and items frequently used by pharmacists rather than use instructions or medication warnings. The content of warning and instruction stickers is highly variable depending on the pharmacy selected.
用药错误频繁发生，药品标签不佳被认为是一个潜在原因。我们评估了社区药房所配发处方药容器标签的格式、内容及变异性。
在4个城市（波士顿、芝加哥、洛杉矶和得克萨斯州奥斯汀）的6家药房（2家最大的连锁药房、2家杂货店和2家独立药房）中，填写4种常用药物（阿托伐他汀钙[立普妥]、阿仑膦酸钠[福善美]、甲氧苄啶-磺胺甲恶唑[复方新诺明]和布洛芬）的相同处方。对主容器标签和辅助贴纸的格式及内容特征进行评估。标签由2名摘要员独立编码，差异通过协商一致解决。
在排除11份用无药房打印标签的非处方容器盛装的布洛芬处方后，我们评估了85个标签。71个（84%）标签上最突出的项目是药房名称或标识，平均字体大小为13.6磅。用药说明（9.3磅）、药品名称（8.9磅）以及警示和说明贴纸（6.5磅）的字体较小。颜色、加粗和突出显示最常用于标识药房以及对药剂师最有用的项目。虽然主标签的内容总体一致，但不同药房的说明和警示贴纸内容存在很大差异，且独立药房使用此类贴纸的可能性较小（P < 0.001）。没有一个布洛芬容器按照法律要求随附美国食品药品监督管理局批准的用药指南。
大多数容器标签的格式强调药房特征以及药剂师常用的项目，而非使用说明或药品警示。警示和说明贴纸的内容因所选药房而异。
