Abstract
The aging process has been and is still a concern for humanity. Although some may consider old age as the peak of wisdom and tranquility, this process is accompanied by the development of various diseases, contributing to increased polypharmacy. In this age range, due to pharmacokinetic and pharmacodynamic changes, polypharmacy becomes complex due not only to physiological declining but also to decreased cognitive abilities that are crucial in a correct medication management.
Pictograms are particularly useful for conveying information related to medication especially for patients with low health literacy. Several studies confirm that its inclusion in informative materials positively influences the patient’s attention, understanding, recall and adherence to treatment, demonstrating its potential for medication management in the elderly. This study describes and analyzes the results of the use of pictograms on medication management and adherence by elderly patients, through a systematic literature review based on the pre-defined methodological approach described in the Preferred Reporting Items for Systematic reviews and Meta-Analyzes (PRISMA).
In total, fourteen studies that met the defined inclusion criteria were included in the review. The studies were heterogeneous regarding the study design, population size and types of results. The interventions showed positive results promoting greater patient adherence to treatment and controlling problems related to the incorrect use of medication, however, the specific results reinforce the need for further studies in this area to provide a more complete approach about the use of pictograms in health care, namely digital devices, especially in this age range.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Galvão, C.: O idoso polimedicado - Estratégias para melhorar a prescrição. Rev. Port. Med. Geral e Fam. 22(6), 747–752 (2006)
Vaillancourt, R., Giby, C.N., Murphy, B.P., Pouliot, A., Trinneer, A.: Recall of pharmaceutical pictograms by older adults. Can. J. Hosp. Pharm. 72(6), 446–454 (2019). PMID: 31853145
Maddigan, S.L., Farris, K.B., Keating, N., Wiens, C.A., Johnson, J.A.: Predictors of older adults’ capacity for medication management in a self-medication program: a retrospective chart review. J. Aging Health 15(2), 332–352 (2003)
Renpenning, K.M., Taylor, S.G.: Self-Care Theory in Nursing: Selected Papers of Dorothea Orem. Springer, New York (2003)
Puspitasari, H.P., Aslani, P., Krass, I.: A review of counseling practices on prescription medicines in community pharmacies. Res. Soc. Adm. Pharm. 5(3), 197–210 (2009)
Merks, P., Świeczkowski, D., Balcerzak, M., Drelich, E., Białoszewska, K., Cwalina, N., Krysinski, J., Jaguszewski, M., Pouliot, A., Vaillancourt, R.: The evaluation of pharmaceutical pictograms among elderly patients in community pharmacy settings – a multicenter pilot study. Patient Prefer. Adherence 12, 257–266 (2018)
Kolers, P.: Some formal characteristics of pictograms. Am. Sci. 57, 348–363 (1969)
Barros, I.M.C., Alcântara, T.S., Mesquita, A.R., Santos, A.C., Paixão, F.P., Lyra Jr., D.P.: The use of pictograms in the health care: a literature review. Res. Social Adm. Pharm. 10(5), 704–719 (2014)
Davies, S., Haines, H., Norris, B., Wilson, J.R.: Safety pictograms: are they getting the message across? Appl. Ergon. 29, 15–23 (1998)
Dowse, R., Ehlers, M.: Medicine labels incorporating pictograms: do they influence understanding and adherence? Patient Educ. Couns. 58, 63–70 (2005)
Paivio, A.: Imagery and Verbal Processes. Holt, Rinehart, and Winston, New York (1971)
Dual Coding and Common Coding Theories of Memory (2014). http://plato.stanford.edu/entries/mental-imagery/theories-memory.html. Accessed 28 Sept 2020
Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G.: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Syst. Rev. 4 (2009). p. 1. https://doi.org/10.1186/2046-4053-4-1
Berthenet, M., Vaillancourt, R., Pouliot, A.: Evaluation, modification, and validation of pictograms depicting medication instructions in the elderly. J. Health Commun. 21, 27–33 (2016)
Dowse, R., Ehlers, M.S.: The evaluation of pharmaceutical pictograms in a low-literate South African population. Patient Educ. Couns. 45(2), 87–99 (2001)
Fukuda, Y., Ando, S., Saito, M.: Effect of a Japanese drug alert pictogram on medication-taking/driving behavior. Traffic Inj. Prev. 21(1), 18–23 (2019)
Gazmararian, J., Jacobson, K.L., Pan, Y., Schmotzer, B., Kripalani, S.: Effect of a pharmacy-based health literacy intervention and patient characteristics on medication refill adherence in an urban health system. Ann. Pharmacother. 44(1), 80–87 (2010)
Hawkins, L.A., Firek, C.J.: Testing a novel pictorial medication sheet to improve adherence in veterans with heart failure and cognitive impairment. Heart Lung 43(6), 486–493 (2014). 100
Kim, J., Fnu, V., Bell, E., Kim, H.: Feasibility of the rule-based approach to creating complex pictograms. Stud. Health Technol. Inform. 225, 397–401 (2016)
Leong, M., Tam, V., Xu, T., Peters, M.: Understanding medication schedules: do pictograms help? J. Patient Saf. 14(2), e19–e24 (2017)
Poureslami, I., Nimmon, L., Doyle-Waters, M., Rootman, I., Schulzer, M., Kuramoto, L., et al.: Effectiveness of educational interventions on asthma self-management in Punjabi and Chinese asthma patients: a randomized controlled trial. J. Asthma 49(5), 542–551 (2012)
Cordasco, K.M., Asch, S.M., Bell, D.S., Guterman, J.J., Gross-Schulman, S., Ramer, L., et al.: A low-literacy medication education tool for safety-net hospital patients. Am. J. Prev. Med. 37(6), S209–S216 (2009)
Schillinger, D., Machtinger, E.L., Wang, F., Chen, L.-L., Win, K., Palacios, J., et al.: Language, literacy, and communication regarding medication in an anticoagulation clinic: are pictures better than words? In: Henriksen, K., Battles, J.B., Marks, E.S., Lewin, D.I. (eds.) Advances in Patient Safety: From Research to Implementation (Volume 2: Concepts and Methodology). Agency for Healthcare Research and Quality (US), Rockville (2005)
Kripalani, S., Robertson, R., Love-Ghaffari, M.H., Henderson, L.E., Praska, J., Strawder, A., et al.: Development of an illustrated medication schedule as a low-literacy patient education tool. Patient Educ. Couns. 66(3), 368–377 (2007)
Kripalani, S., Schmotzer, B., Jacobson, T.A.: Improving medication adherence through graphically enhanced interventions in coronary heart disease (IMAGECHD): a randomized controlled trial. J. Gen. Intern. Med. 27(12), 1609–1617 (2012)
Knapp, P., Raynor, D.K., Jebar, A.H., Price, S.J.: Interpretation of medication pictograms by adults in the UK. Ann. Pharmacother. 39(7–8), 1227–1233 (2005)
Advinha, A.M., Henriques, A., Guerreiro, M.P., Nunes, C., Lopes, M.J., Oliveira-Martins, S.: Cross-cultural validation of the drug regimen unassisted grading scale (DRUGS) to assess community-dwelling elderly’s ability to manage medication. Eur. Geriatr. Med. 7, 424–429 (2016)
Advinha, A.M., De Barros, C.T., Guerreiro, M.P., Nunes, C., Lopes, M.J., Oliveira-Martins, S.: Cross-cultural validation and psychometric evaluation of the self-medication assessment tool (SMAT) for assessing and optimizing medication therapy management of older people. Eur. J. Pers. Centered Healthc. 6, 655 (2018)
Camacho, B.: Design e avaliação de pictogramas farmacêuticos. Ph.D. thesis. Universidade de Aveiro, Aveiro (2013)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this paper
Cite this paper
Faustino, S., Oliveira-Martins, S., Advinha, A.M. (2021). Pictograms - A Useful (Digital and/or Physical) Tool to Assist Elderly Patients in Understanding Medication Instructions? – A Systematic Review. In: García-Alonso, J., Fonseca, C. (eds) Gerontechnology III. IWoG 2020. Lecture Notes in Bioengineering. Springer, Cham. https://doi.org/10.1007/978-3-030-72567-9_19
Download citation
DOI: https://doi.org/10.1007/978-3-030-72567-9_19
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-72566-2
Online ISBN: 978-3-030-72567-9
eBook Packages: MedicineMedicine (R0)