Factors that Facilitate and Hinder the Comprehension of Patient Information Leaflets (PILs): A Brief Scoping Review

Introduction: Patient information leaflets (PILs) of medicinal products are informative documents that accompany medicines and explain their components, modes of use, interactions with other medicines, and other relevant issues. When patients do not adequately understand the information in the leaflets, they may engage in behaviors that affect their health (e.g., self-medication).Objective: To identify patient-related factors and characteristics of PILs that can promote cognitive, emotional, and behavioral changes that lead to appropriate drug use practices. Additionally, we aimed to determine strategies that could be implemented to design leaflets that convey adequate information and are easier to understand.Method and Results: We evaluated scientific articles published in databases and containing information on PILs suitability to be used in a patient population. A total of 51 articles were selected as the sample. Certain leaflet factors that favored or hindered understanding were identified (e.g., format in which the leaflets are presented, their structure, their adaptation to the sociodemographic and linguistic characteristics of the population, their wording…). Similarly, we also identified patient factors, such as previous experience taking the drugs referred to in the leaflet; the type of emotions experienced when reading the leaflets; the emphasis on the adverse effects of the medications; sociodemographic variables (i.e., age or educational level); and degree of interest in their own healthcare.Conclusion: Patient and leaflet factors influence the comprehension of information in the PIL; hence, emphasis should be placed on these factors to increase treatment and medication adherence and to reduce health-risk behaviors.

Translation of patient information leaflets: Trained translators and pharmacists-cum-translators – a comparison

Numerous studies have shown that Patient Information Leaflets (PILs) are generally difficult to understand for ordinary people and that this may be one of the reasons why a high percentage of patients fail to take their medication correctly. A study by Askehave and Zethsen (2002), based on textual analysis and relying on comprehensive extratextual procedural knowledge, has shown that translated Danish PILs were, without exception, more complex than their STs. But why is this so? One possible explanation could be that PILs are very frequently translated by pharmacists, who do not possess the linguistic tools and translational knowledge necessary for expert-to-layman translation or interlingual translation. This article reports on an empirical study that falls into two parts. The first aims to identify possible differences in the translations of these two types of translator in terms of lay-friendliness. The second aims to describe the nature of the differences found between these two types of translator, and discusses whether they could potentially be detrimental to lay-friendliness in PILs.

Legibility of Pharmaceutical Pictograms

The design of medicinal information in leaflets and labels is often criticized for not meeting patients' needs. For that reason, there is an increasing focus on how the use of pictures, such as pictograms, may benefit patients on their medical journey. However, before a pictogram can be comprehended it must be legible, which may be a challenge when pharmaceutical information has to be conveyed. Within a limited space many visual details need to be included in order to clarify the intended meaning. While we have abundant information about the comprehension of pictograms, we know very little about the legibility - the ability to visually identify objects - of pictograms. By looking at legibility research into pharmaceutical pictograms from a design perspective, this paper demonstrates that legibility is not prioritized either in theory or in practice. In order to proceed with the use and implementation of pictograms in, for example, patient information leaflets and labels, we need to know more about the features that constitute legibility. To create a research foundation, this paper draws on knowledge of visibility and legibility from related domains. This forms the basis of a discussion of the need for future research to focus on legibility issues, amongst others by incorporating design knowledge into experiments.