Malhotra Rahul, Tan Yi Wen, Suppiah Sumithra Devi, Tay Sarah Siew Cheng, Tan Ngiap Chuan, Liu Jianying, Koh Gerald Choon-Huat, Chan Alexandre, Vaillancourt Régis
Centre for Ageing Research & Education, Duke-NUS Medical School, Singapore.
Health Services and Systems Research, Duke-NUS Medical School, Singapore.
PEC Innov. 2022 Dec 9;2:100116. doi: 10.1016/j.pecinn.2022.100116. eCollection 2023 Dec.
In an earlier study, several tested International Pharmaceutical Federation (FIP) pictograms did not achieve validity among older adults in Singapore. In this study, for 27 unvalidated FIP pictograms, we (1) developed variants of each pictogram, (2) elicited the most-preferred variant, and (3) assessed the validity of the most-preferred variant among older Singaporeans.
In phase 1, up to three variants of the 27 pictograms were developed, based on older adults' feedback from a previous study. In phase 2, the most-preferred variant of 26 pictograms, which had two or three variants, was selected by 100 older participants. In phase 3, the 27 most-preferred variants (including the pictogram with only one variant) were assessed for validity - transparency and translucency - among 278 older participants (10 pictograms per participant). To evaluate transparency, participants were first asked: "" for each assigned pictogram. If they responded, they were asked, , and if not, they were told, ". Then, participants were shown their assigned pictograms again, one by one, and the pictogram's intended meaning was revealed to evaluate translucency. Pictograms were classified as valid (≥66% participants interpreted its intended meaning correctly [transparency criterion] and ≥85% participants rated its representativeness as ≥ 5 [translucency criterion]), partially valid (only transparency criterion fulfilled) or not valid.
In phase 1, 77 variants of the 27 pictograms were developed. In phase 2, a majority of the most-preferred variants were selected by >50% participants. In phase 3, 10 (37.0%) of the 27 pictograms tested were considered valid, and five (18.5%) were partially valid. A higher proportion of pictograms portraying dose and route of administration and precautions were valid or partially valid, versus those depicting indications or side effects.
Contextual redesigning and selection of pharmaceutical pictograms, which initially failed to achieve validity in a population, contributed to their validation.
The redesigned validated pictograms from this study can be incorporated into relevant patient information materials in clinical practice.
在一项早期研究中，国际药学联合会（FIP）测试的几个象形图在新加坡老年人中未达到有效性。在本研究中，对于27个未经验证的FIP象形图，我们（1）开发了每个象形图的变体，（2）找出最受青睐的变体，以及（3）评估最受青睐的变体在新加坡老年人中的有效性。
在第1阶段，根据先前研究中老年人的反馈，为27个象形图开发了多达三个变体。在第2阶段，100名老年参与者从有两个或三个变体的26个象形图中选出了最受青睐的变体。在第3阶段，对278名老年参与者（每人10个象形图）评估了27个最受青睐的变体（包括只有一个变体的象形图）的有效性——透明度和半透明度。为了评估透明度，首先询问参与者：“对于每个分配的象形图。”如果他们回答了，接着问“，如果没有回答，就告知他们”。然后，再次逐个向参与者展示他们分配的象形图，并揭示象形图的预期含义以评估半透明度。象形图被分类为有效（≥66%的参与者正确解释了其预期含义[透明度标准]且≥85%的参与者将其代表性评为≥5[半透明度标准]）、部分有效（仅满足透明度标准）或无效。
在第1阶段，为27个象形图开发了77个变体。在第2阶段，大多数最受青睐的变体被超过50%的参与者选中。在第3阶段，测试的27个象形图中有10个（37.0%）被认为有效，5个（18.5%）部分有效。与描绘适应症或副作用的象形图相比，描绘剂量、给药途径和注意事项的象形图中有效或部分有效的比例更高。
对最初在人群中未达到有效性的药品象形图进行情境重新设计和选择有助于其验证。
本研究重新设计并经验证的象形图可纳入临床实践中的相关患者信息材料。
