TORONTO 鈥� Trying to decipher dose instructions written in small print on prescription medications or over-the-counter drug labels can be a daunting task for people with vision impairment or eyesight dimmed by age, say experts, who warn that squint-producing lettering can lead to potentially serious medication errors.
鈥淚 think there are risks for increasing people鈥檚 anxiety in taking medications if you can鈥檛 read it very clearly, or you have to struggle to read it,鈥� says Susan Leat, a professor in the department of optometry and vision science at the University of Waterloo. 鈥淪ome people may be able to read it, but it鈥檚 just harder than it needs to be or takes them longer.鈥�
Leat says being unable to make out instructions on medication labels may also lead to a lack of independence, as patients have to rely on others to relay the information.
鈥淵ou have to remember many people are taking two or three medications or more even. Some are taking up to 15 different medications a day,鈥� she says. 鈥淭hey need to sort them out into 鈥楾his one, I take two times, this one I take four times.鈥�
鈥淪o having to rely on somebody else to do that because you can鈥檛 read the information very well takes away people鈥檚 independence, and their privacy as well.鈥�
While there are some guidelines for how pharmacies should present information on drug container labels, legislation in Canada only covers what critical information must appear on packaging 鈥� not how it looks.
Font size, whether letters are upper or lower case, word spacing and highlighting of certain words can make a huge difference to legibility, says Leat, who led a recent study that looked at prescription drug labels from a random sampling of 45 pharmacies in Kitchener-Waterloo and Cambridge in southwestern Ontario.
The pharmacies 鈥� both those from large chains and independents 鈥� were each asked to print out a medication label, using the same made-up patient name, drug and dosage supplied by the researchers.
The authors then analyzed the legibility of what鈥檚 known as 鈥減atient-critical鈥� information 鈥� the instructions for when to take the medication and how much, the name of the drug and the patient鈥檚 name.
Leat says more than 90 per cent of the pharmacies followed guidelines for font type 鈥� a plain style without flourishes, or sans serif 鈥� high-contrast lettering, black instead of coloured print, and non-glossy paper.
鈥淏ut in terms of some other aspects, they were not so good,鈥� she says.
Many of the labels used all upper-case letters, even though recommendations suggest using sentence-style, which means a combination of upper- and lower-case lettering, as one would see in a book or newspaper.
Spacing was also found to be an issue with some labels, says Leat. 鈥淵ou don鈥檛 want the print all squished up together. You want to make the best use of space between the lines of print, because people with vision impairment and older people are generally going to have more difficulty when it鈥檚 crowded together.鈥�
Highlighting certain words or phrases, such as instructions that say, for instance, 鈥渢ake two pills, three times a day,鈥� is also helpful.
鈥淏ut very few actually highlighted the instructions in that way,鈥� she says. 鈥淎nd when they did ... they used grey highlighting, which is not very good. Usually a bright yellow highlighting is probably better to bring people鈥檚 attention to that part of the label.鈥�
And when it came to the all-important font size, only 44 per cent met the recommendation to use 12-point lettering, the smallest size considered to provide ease of reading, say the authors, whose paper was published recently in the 91原创 Pharmacists Journal.
鈥淲e should be aiming for a minimum of 12-point, and bigger if possible,鈥� says the optometrist, who ideally would like to see legislation governing how labels must be printed.
Having a standard labelling format among pharmacies would also help consumers, who may get their prescriptions from different drug stores.
鈥淪ome of the labels, they put the patient name first and the instructions afterwards,鈥� Leat says. 鈥淪ome of them put the drug name first and then the patient name. There鈥檚 no consistency in where the different pieces of information are on the label.
鈥淪o patients would not know where to look on the label to find the particular thing that they鈥檙e looking for.鈥�
