ADD A LANGUAGE! ADD A PICTURE!—IMPROVING PRESCRIPTION MEDICATION LABELS FOR ELDERLY SINGAPOREANS
Rahul Malhotra, M.C. Bautista, Ngiap Chuan Tan, Wing Him Tang, Sarah Siew Cheng Tay, A.L. Tan, Annie Pouliot, Régis Vaillancourt · Innovation in Aging · 2017
In Singapore, medication labels placed by clinics on packets/bottles of dispensed prescription medications are primarily in English. This poses a challenge for elderly Singaporeans (≥65 years) as 61% of them cannot read in English. However, nearly half of them can read in ≥1 of the other three official languages (Chinese/Malay/Tamil), thus suggesting a potential strategy, i.e., adding another language, for improving prescription medication labels. Pictograms, shown to be helpful for low-literacy populations elsewhere, are another potential strategy. We assessed the utility of these strategies, i.e., bilingual labels and/or labels with pictograms, in improving the understanding of medication labels among elderly Singaporeans. Respondents were randomized to 4 different label types - (A) English-text (n=357); (B) English-text with pictograms (n=357); (C) Bilingual-text (n=353); and (D) Bilingual-text with pictograms (n=350) - for the same three medications, and questioned on their understanding of the label content. While 65% of those randomized to Type A reported difficulty reading the labels, corresponding proportions were significantly lower with the addition of pictograms and/or another language (57%, 32%, 37%, for types B, C, D, respectively). However, even among those able to read English, 12%, 14%, 10% and 9%, respectively across each label type still reported difficulty. Use of bilingual medication labels is a promising strategy for improving prescription medication labels for elderly Singaporeans. However, careful assessment of the label design and content and of non-label-related factors that may limit the elderly’s understanding is warranted. Our findings can support future empirical studies evaluating real-world prescription medication labels for elderly Singaporeans.