Abstract
Adding icons on labels of acetaminophen-containing medicines could help users identify the active ingredient and avoid concomitant use of multiple medicines containing acetaminophen. We evaluated five icons for communication effectiveness. Adults (n = 300) were randomized to view a prescription container label or over-the-counter labels with either one or two icons. Participants saw two icon candidates, and reported their interpretation; experts judged whether these reflected critical confusions that might cause harm. Participants rated how effectively each icon communicated key messages. Icons based on abbreviations of “acetaminophen” (“Ac”, “Ace”, “Acm”) were rated less confusing and more effective in communicating the active ingredient than icons based on “APAP” or an abstract symbol. Icons did not result in critical confusion when seen on a readable medicine label. Icon implementation on prescription labels was more effective at communicating the warning against concomitant use than implementation on over-the-counter (OTC) labels. Adding an icon to a second location on OTC labels did not consistently enhance this communication, but reduced rated effectiveness of acetaminophen ingredient communication among participants with limited health literacy. The abbreviation-based icons seem most suitable for labeling acetaminophen-containing medications to enable users to identify acetaminophen-containing products.
Highlights
Acetaminophen is an analgesic and antipyretic widely used in both non-prescription (OTC)and prescription (Rx) medicines
Abbreviation-based icons (“Ac,” “Ace,” and “Acm”) were more effective than “APAP” and an abstract icon at communicating that acetaminophen was an ingredient in medicine, and that users should avoid concomitant use with other medicines containing acetaminophen
When seen in a realistic context, most people did not find these icons confusing, and most understood that they designated the active ingredient acetaminophen
Summary
Acetaminophen is an analgesic and antipyretic widely used in both non-prescription (OTC). Acetaminophen is safe when used as directed, but overdose can lead to liver injury [2]. Administration, have expressed concern about unintentional acetaminophen overdose [3,4]. OTC acetaminophen medicine labels identify acetaminophen as an ingredient and warn against concomitantly using multiple acetaminophen medicines, an important root cause of unintentional overdose is failure to identify acetaminophen as an ingredient and subsequent concomitant use of multiple acetaminophen medicines [5]. A diary study [6] found that concomitant use of multiple acetaminophen medicines was associated with exceeding the maximum daily dose, as was use of multiple medication types (e.g., OTC and Rx) within a day.
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