Original Article

Journal of General Internal Medicine

, Volume 24, Issue 5, pp 570-578

Can Improved Prescription Medication Labeling Influence Adherence to Chronic Medications? An Evaluation of the Target Pharmacy Label

  • William H. ShrankAffiliated withDepartment of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School Email author 
  • , Patrick P. GleasonAffiliated withPrime Therapeutics
  • , Claire CanningAffiliated withDepartment of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School
  • , Carol WaltersAffiliated withPrime Therapeutics
  • , Alan H. HeatonAffiliated withBlue Cross Blue Shield of Minnesota
  • , Saira JanAffiliated withHorizon Blue Cross Blue Shield of New Jersey
  • , Amanda PatrickAffiliated withDepartment of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School
  • , M. Alan BrookhartAffiliated withDepartment of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School
  • , Sebastian SchneeweissAffiliated withDepartment of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School
    • , Daniel H. SolomonAffiliated withDepartment of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School
    • , Jerry AvornAffiliated withDepartment of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School
    • , Niteesh K. ChoudhryAffiliated withDepartment of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School

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Abstract

BACKGROUND

Prescription medication labels contain valuable health information, and better labels may enhance patient adherence to chronic medications. A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve readability and understanding.

OBJECTIVE

We evaluated whether the new Target label influenced patient medication adherence.

DESIGN AND PATIENTS

Using claims from two large health plans, we identified patients with one of nine chronic diseases who filled prescriptions at Target pharmacies and a matched sample who filled prescriptions at other community pharmacies.

MEASUREMENTS

We stratified our cohort into new and prevalent medication users and evaluated the impact of the Target label on medication adherence. We used linear regression and segmented linear regression to evaluate the new-user and prevalent-user analyses, respectively.

RESULTS

Our sample included 23,745 Target users and 162,368 matched non-Target pharmacy users. We found no significant change in adherence between new users of medications at Target or other community pharmacies (p = 0.644) after implementing the new label. In prevalent users, we found a 0.0069 percent reduction in level of adherence (95% CI −0.0138-0.0; p < 0.001) and a 0.0007 percent increase in the slope in Target users (the monthly rate of change of adherence) after implementation of the new label (95% CI 0.0001–0.0013; p = 0.001).

CONCLUSIONS

We found no changes in adherence of chronic medication in new users, and small and likely clinically unimportant changes in prevalent users after implementation of the new label. While adherence may not be improved with better labeling, evaluation of the effect of labeling on safety and adverse effects is needed.

KEY WORDS

label prescription medication adherence