Strategies to optimize comprehension of numerical medication instructions: A systematic review and concept map |
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| Affiliation: | 1. Dept. of Population Health Sciences, Division of Health Informatics, Weill Cornell Medical College, New York, NY, USA;2. Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA;3. Department of Biomedical Informatics, Columbia University, New York, NY, USA;4. Weill Cornell Medicine Samuel J Wood Library, New York, NY, USA;5. Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA;1. Maastricht University, Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands;2. Maastricht University, Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands;3. RCSI University of Medicine and Health Sciences, Health Professions Education Centre, Dublin, Ireland;1. University of Kansas School of Medicine, Department of Population Health, Kansas City, KS USA;2. University of Kansas School of Nursing, Kansas City, KS USA;1. Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium;2. Department of Palliative Care, University Hospitals Leuven, Belgium;3. LUCAS KU Leuven Centre for Care Research & Consultancy, Leuven, Belgium;4. Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium;5. Department of Oncology, KU Leuven, Leuven, Belgium;1. Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany;2. University of Education Freiburg, Department of Public Health and Health Education, Germany;3. Beuth University of Applied Sciences, Berlin, Germany;4. Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany;1. Radboud University, Department of Gender & Diversity Studies, Radboud Social Cultural Research, Nijmegen, the Netherlands;2. Radboud University, Department of Language and Communication, Centre for Language Studies, Nijmegen, the Netherlands |
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| Abstract: | ObjectiveTo develop evidence-based recommendations for improving comprehension of quantitative medication instructions.MethodsThis review included a literature search from inception to November 2021. Studies were included for the following: 1) original research; 2) compared multiple formats for presenting quantitative medication information on dose, frequency, and/or time; 3) included patients/lay-people; 4) assessed comprehension-related outcomes quantitatively. To classify the studies, we developed a concept map. We weighed 3 factors (risk of bias in individual studies, consistency of findings among studies, and homogeneity of the interventions tested) to generate 3 levels of recommendations.ResultsTwenty-one studies were included. Level 1 recommendations are: 1) use visualizations of medication doses for liquid medications, and 2) express instructions in time-periods rather than times per day. Level 2 recommendations include: validate icons, use panels or tables with explanatory text, use visualizations for non-English speaking populations and for those with low health literacy and limited English proficiency.ConclusionsVisualized liquid medication doses and time period-based administration instructions improve comprehension of numerical medication instructions. Use of visualizations for those with limited health literacy and English proficiency could result in improved outcomes.Practice implicationsPractitioners should use visualizations for liquid medication instructions and time period-based instructions to improve outcomes. |
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| Keywords: | Medication instructions Adherence Format variations Numerical interventions Pictograms |
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