Hands up those of you who read the labels on your medication bottles ‘every’ time you’re due to administer a dose? Not many of you I bet. While much publicity highlights the dangers of counterfeit drugs (and rightly so), what about the dangers linked to incorrectly taking genuine medication?

Approximately 90 million adults in the US struggle to understand and correctly act upon common standard drug warnings on prescription bottles, according to estimates from The Institute of Medicine. Many adults are, therefore, at risk of either not receiving the full therapeutic benefits of their prescription (through under dosing), or experiencing unpleasant side effects (through over dosing). 

A new study from Northwestern University Feinberg School of Medicine (IL, USA) suggests that simplifying both the language and icons used on standard warning labels for prescription medicine can significantly help patients to understand how to take their medication correctly. Many of the words and icons in use have been so for decades without any evidence to support patient comprehension. Michael Wolfe, Associate Professor of medicine and learning sciences at Feinberg, and lead author of the study said in a recent press release: “The study shows the value of a clear message…. A lot of the current warnings were phrased very abstractly and were confusing. For example, we changed ‘For external use only’ to ‘Use only on your skin.’ We moved from the intangible to the concise.” 

In addition, the researchers also recommend limiting the number of warnings to two so that only the most important are printed: the study indicated that if there are too many warnings patients tend to ignore them. Wolfe advised in a press release: “We need to figure out which are the most important warnings and only put those on the label.  Otherwise you risk the message never reaching the patient…. The more warnings you put on a label, the more you distract them from essential instructions and precautions that ensure they safely use the medicine.” 

Furthermore, the study also discovered that patients with low literacy were at greatest risk of misunderstanding instructions and, therefore, more liable to misuse medications. The researchers and patients of the study worked with graphic designers to create new icons that captured the mental images of what the warnings meant. For example, “A current and widely used icon of a pregnant woman resembles an olive,” Wolf said in a press release. “For most people that probably doesn’t convey pregnancy. The new design of a silhouette of a pregnant woman with a bump on her stomach was more easily recognizable to patients.” 

Work is already underway to revamp the content of prescription warning labels as Wolfe and colleagues from Emory, Harvard and Louisiana State universities have teamed up with the US Pharmacopeia to create a drug labelling task force.

 Simplifying language, particularly warnings on prescription bottles, is definitely a positive move, but I will be interested to learn how feasible it will be to whittle the warnings down to the recommended limit of two. How will the drugs companies fare in this age of compensation?