04 Aug 2009  |  by Gini Niles

Prescription labels: Where are we now?


As a firm, we are interested in how design can contribute to improved patient outcomes. We know some design efforts are underway to reduce confusion and deliver more meaningful information on prescription labels, but labeling doesn’t seem to have changed much. So, I set out to learn where those efforts stand. Here’s what I found…

There’s a problem with prescription labeling

Shrank et al. found that variability among label designs, as well as poorly executed information hierarchy, leads to patient confusion and misinterpretation. Low literacy levels is another such factor that can lead to the misunderstanding of prescription labels. According to another study, patient confusion is in direct correlation with their level of literacy.

The FDA requires that certain information be included on the label but there are no recommendations for type size, color, or placement of information. Because FDA standards don’t address label design, pharmacies are left to fit legal requirements on the label with no particular hierarchy or order.

One study published in the Archives of Internal Medicine, found that while some pharmacies are using color, bold type, and large font sizes, it is typically used to enhance only the pharmacy’s information. Pharmacy logo and slogan, and pharmacy telephone number and address were set in a large type size, while patient information and medication instructions were set in a small type size.

Design efforts seek to reduce confusion

  • The Seventh Annual National Health Communication Conference highlighted prescription label improvement in 2008.
  • Michael Wolf, PhD, assistant professor of medicine at Northwestern University’s Feinberg School of Medicine, proposes a complete redesign and standardization of the text and format of prescription medication labels.
  • Target launched ClearRx four years ago. Deborah Adler was inspired to redesign the prescription label for her masters thesis when her grandmother and grandfather accidentally switched their medications. Deborah shopped her design around to various companies when Target expressed interest in the project. Clear typography, smart color coding, and flat surfaces for easier reading are all components of the new design. Subsequently, Target provided a grant to Dr. Wolf to redesign the warning icons and usage instructions. 
Target ClearRx label and package design
  • The Walgreen Company is implementing a program that provides translations of medication information in several languages.
  • EasyRead. Weber Shandwick helped CVS/Pharmacy, the nation’s largest retail pharmacy, develop the EasyRead prescription label. The label uses a larger typeface and a cleaner layout. It also includes a physical description of the prescribed pill to help customers identify their medications.

EasyRead label

Help us learn more

If you are aware of more recent progress in the area of prescription label design or have any other resources of note, feel free to comment and share what you know.

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8 Responses to “Prescription labels: Where are we now?”

  1. Amy Cueva says:

    Great topic!

    Some ideas, in addition to the name of the med and directions on how/when to take being clear and large:

    “Shudder to think” that some may not not what amoxicillin is. Meaning a simple definition should be included: “Antibiotic used to treat bacterial infections”. For example…

    Why not have a picture of the pill on the outside, so that you don’t have to look inside to see what they look like, and you can use the bottle to identify pills that turn up.

    If it is a generic could the brand name which it replaces be referenced?

    I do think it would be great to have side effects, interactions and warnings clearly and plainly described as is suggested in this article.

    How about a URL for more information?

    Reference a “PatientsLikeMe” type of website to see what people think about this drug.

    The color codes could be used for different family members or for different conditions.

    Again – great topic – thanks!

  2. Amy Cueva says:

    Oh, one more, information on how to refill the prescription and info on how to get reminders for refills, bulk orders, etc.

  3. and it’s true, the print gets smaller as the eyes get older! Also great to see the work on container design – it seems there is always a drawer or shelf that is just a big jumble of random containers that don’t fit together and are repeatedly fumbled through while attempting to locate ‘the one’.

  4. Chris Barnes says:

    Great ideas, Amy. And your suggestion Jeffrey makes me think of bottles that snap together to indicate the order they should be taken, or simply to manage clutter. Lots of possibilities.

    It’s a fascinating conundrum, isn’t it? Too much information to be included on a conveniently sized bottle, but the info is also too important to be left off.

    What if we envision the future a little further out?… What about an embedded chip? Bottle could be read by a networked scanner at home, and all related info displayed on tv/computer/phone screen or a digital photo frame. One can imagine voice reminders, automated re-orders, links to MDs office. Perhaps the scanner could even identify spilled pills and show a picture of the correct bottle.

    BUT, one interesting aspect to prescription packaging and label design are the thorny systems issues. For instance: regulatory issues (child-proof caps); required changes to pharmacy management software; and who bears cost of more expensive packaging (and design), etc.?

    We received updated information from some experts and researchers in the field today, including studies on efficacy of redesigned labels…we’ll update the blog posting when we can.

  5. Janna Kimel says:

    Great topic, great ideas! I think about the scanners the nurses have at hospitals and wonder if there might not be a smaller version for the home. Two elderly people – or heck, any two of us, might pick up the wrong amber bottle. I’ve taken the wrong meds at the wrong time of day, so perhaps it could help with that as well.

    I also wish someone would re-design the horrible paperwork that comes with medications. It’s confusing and scary. We need a consistent set of icons and, again, a hierarchy of information.

    I’ve looked into smart packaging that would tell a user when to take a pill and what side effects to expect. One might even give a window of efficacy … a bottle would give a warning sound if you try to open it outside the suggested dose times.

    A few more links for you: http://www.orcatech.org/papers/EMBS_07_Lundell.pdf

    And we have a chapter in this book on some pill reminder design: http://tinyurl.com/pg3ere

  6. The biggest issue, as I see it, is that prescription labels are trying to be all things to all people at all times — and no manufacturer has really taken a holistic look at this since Target.

    First of all, there’s the whole problem of timeliness of information. You need different information for:
    – preparing the prescription
    – pickup
    – organizing the prescription
    – taking the prescription
    – reordering

    Not all of that information needs to be visible at all times. In fact, pharmacy / reordering information could be in fortune-cookie strip on this inside, not on the label.

    Secondly, the information a pharmacist needs is different from that of a patient or a caregiver. The one-size-fits-all approach needs to be rethought.

    Even the best typography and layout won’t help with information overload in a limited amount of real estate. Labels need to be rethought and designed more like software or mobile interfaces, where you onyl see the information you need, when you need it.

  7. Chris Barnes says:

    Well put, Claudio, I couldn’t agree more — the real need is for holistic solutions that provide variable, on-demand information tailored to the situation and/or audience.

    I like the way you described information needs in terms of workflow. I suspect that emergency situations (poison control, or emergency responders) might present another discrete need. In addition to workflow, a truly holistic prescription information solution might attempt to close the loop back to outcomes by helping to track adherence, efficacy, and side effects.

  8. Gini Niles says:

    Thanks for your comments and ideas. As Chris mentioned, I received several new sources from experts studying prescription packaging. Here is an update…

    Although Target’s ClearRx was implemented four years ago, little research has been done to measure the effect of the new design. Shrank et al found no significant changes in adherence of chronic medication in two populations of ClearRx customers http://tinyurl.com/laevov. Further evaluation of the ClearRx label’s effect on patient safety, understanding, and adherence is still necessary. It will be interesting to see if other companies follow Target’s lead in developing a systems-based prescription packaging solution. Especially without evidence-based data to back up the need for improvement.

    Janna, In 2007, the FDA implemented new regulations involving the medication paperwork you’ve described as confusing and scary http://tinyurl.com/nnwp8k. Though it’s hard to imagine that you’ll see changes any time soon since the FDA merely suggests that drug makers comply with the new labeling requirements and only on a voluntary basis. Alas, a step forward, if only a baby step.

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