DO PRESCRIPTION PICTOGRAMS IMPROVE UNDERSTANDING OF MEDICATION DIRECTIONS FOR SPANISH SPEAKING PATIENTS?

Purpose: Language barriers exist in the US between Spanish-speaking patients and English- speaking healthcare providers, especially in terms of explaining and understanding proper medication use. This study aimed to measure the understanding of prescription instructions within the Spanish speaking population by using pictograms. The study also aimed to determine if medication instruction comprehension was increased with prescription instructions in Spanish compared to English instructions customarily included. Methods: The investigators constructed a survey to measure the participants' prescription instruction comprehension and utilized a cross-sectional study design to conduct study analyses. The survey included participant demographics, Prescription Instruction Comprehension (PIC) scores, and participant reflections. The survey was conducted throughout the Dallas/Fort Worth Metroplex from June 2012 to August 2012. Participants were recruited from the Bob Mann Medical Clinic in Arlington, TX as well as other locations in the Dallas/Fort Worth Metroplex area. A paired sample T-test was performed to compare the means of participants' Prescription Instruction Comprehension (PIC) scores with the pictogram versus without pictograms as well using prescription instructions written in Spanish versus English. Results: A total of 128 surveys were conducted for this study. There was statistically significant difference between mean PIC score with pictograms (M = 89.76, SD = 16.17), and mean PIC score without pictograms (M = 82.94, SD 20.48), t (114) = 7.56, p < .0005 (2-tailed). A statistically significant difference was found between PIC scores of Spanish instructions (M = 89.76, SD = 16.17) and PIC scores of English instructions (M = 77.97, SD = 22.24), t (114) = 7.98, p < .0005. When participants were asked if pictograms increased their confidence in understanding prescriptions, 84.8% responded "yes." More than half of participants (64.8%) responded "yes" to "would like pictograms included with all of your prescriptions", and 27.2% of the participants responded "yes but with better pictures." Conclusions: Adding pictograms to prescription instructions improved overall understanding for Spanish-speaking participants. This study also found that including prescription instructions in Spanish, the participants' native language, increased correct interpretation of how to take prescription medications. Pictograms also increased participants' confidence for understanding their medication directions.