Abstract
BackgroundPoor communication of medicines information to patients may cause medication errors. We assessed the completeness and readability of dosing instructions provided by pharmacists on dispensing labels and knowledge among patients on dosing instructions of their medicines.MethodsA cross sectional study was conducted in a selected teaching hospital, and a community pharmacy, among 800 patients selected through a systematic sampling method, during a period of 2 months. Completeness of dosing instructions were assessed against a checklist. Patients were asked to read dosing instructions to assess readability. Patient knowledge on dosing instructions were determined through a questionnaire. Completeness, readability and knowledge were scored out of 10 for each dispensing label.ResultsA total of 1200 and 1372 dispensing labels were assessed in the hospital and community settings respectively. The median score out of 10, for completeness, readability and patient knowledge of dosing instructions were 6.7, 8.3 and 7.5 respectively in the hospital, and 7.5, 8.0 and 7.5 respectively in the community. Only a few dispensing labels had the route of administration (hospital, 0.5%; community, 0.8%) and the duration of treatment written (hospital, 0.25%; community, 0.65%) on them. Name (hospital, 48%; community, 27.3%) and strength (hospital, 40.2%; community, 36.6%) of medicines on dispensing labels were frequently misread. In both settings, readability scores significantly differed with education level (P < 0.001).ConclusionsSome important dosing instructions were missing in dispensing labels. Readability of dosing instructions by patients was also not 100% and differed by their education level. Pharmacists did not adhere to a standard procedure in providing dosing instructions leading to communication gaps with patients. Hence we recommend the development of a standard procedure to provide complete, clear and simple dosing instructions to patients, and continuous training for pharmacists on proper communication of dosing instructions to patients.
Highlights
Poor communication of medicines information to patients may cause medication errors
We propose that patients with new and re-fill prescriptions be separated when providing medicines information, develop an essential and compulsory list of the minimum dosing instructions to be provided with any medication
This study is one of the few studies that directly appraised the quality of dosing instructions communicated to patients, by pharmacists, on their dispensed medicines
Summary
Poor communication of medicines information to patients may cause medication errors. We assessed the completeness and readability of dosing instructions provided by pharmacists on dispensing labels and knowledge among patients on dosing instructions of their medicines. Failing to effectively communicate dosing instructions such as, the name, strength, frequency, duration, route of administration and important adverse effects of the medication may be detrimental to the patient. Poor knowledge about their own medications among patients could result in misuse [1] and poor compliance [2], both of which will negatively impact medication safety. We have come across instance where patients have swallowed suppositories and respules indicating the impact of poor medicine knowledge, on medication safety. The magnitude of this problem will increase among older patients as most take a number of medicines at a time [4]
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