Literacy and Misunderstanding Prescription Drug Labels

TO THE EDITOR:

Davis and colleagues (1) have very rightly highlighted the impact of patient literacy on understanding prescription instructions or labels and the subsequent correct use of the medication. Originating from a developing country, where general population illiteracy still remains a harsh reality, I can relate to the viewpoint. However, I also see the vagueness of instructions on prescription labels as an important contributing factor that must not be ignored when considering the issue. This has been pointed out earlier in Brazil (2), Germany (3), and the United States (4). There is a dire need to make the prescription instructions more simplistic, elaborative, and explicit. In my opinion, a simple diagram of the medication use method can serve to greatly improve the medication use practices of general population. Davis and colleagues mentioned that a major proportion of their study participants mistook “teaspoon” for “tablespoon.” Similarly, a study from New Zealand (5) reported that a substantial subset of medication errors in anesthetic practice is erroneous route of drug administration. A simple diagram that depicts the drug dosage and the administration route can cause a substantial reduction in such errors. I agree with the authors that an increase in literacy can improve medication use practices. However, considering the importance of patient safety, alternative approaches to convey medication instructions should be explored. Such techniques may prove valuable for the illiterate populations of many Asian and African countries as well.