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Randomized Controlled Trial
Improving medication understanding among Latinos through illustrated medication lists.
- Arun Mohan, Brian Riley, Brian Schmotzer, Dane R Boyington, and Sunil Kripalani.
- Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322. E-mail: arun.mohan@emory.edu.
- Am J Manag Care. 2014 Dec 1; 20 (12): e547-55.
ObjectivesStrategies are needed to improve medication management among vulnerable populations. We tested the effect of providing illustrated, plain-language medication lists on medication understanding, adherence, and satisfaction among Latino patients with diabetes in a safety net clinic.Study DesignRandomized controlled trial.MethodsIntervention patients received a PictureRx illustrated medication list that depicted the medication, indication, and dosing instructions, accompanied by plain language bilingual text. Usual care patients received a written list of their medications in their preferred language, with indication but no images. Outcomes were assessed by telephone approximately 1 week later. The Medication Understanding Questionnaire measured patients' ability to report the indication, strength, dosing, and frequency for their medication regimen. Self-reported adherence and satisfaction were secondary outcomes. Analysis was performed by intention to treat.ResultsOf 200 enrolled participants, 197 (98.5%) completed follow-up. Most (71%) had not graduated high school, and 59% had low health literacy. Patients randomized to illustrated medication instructions had better overall understanding of their medications (P<.001), including greater ability to report the drug indication (P<.01), strength (P<.05), dosing (P<.01), and frequency of administration (P<.001). Self-reported adherence did not differ significantly between study groups. Patients who received illustrated medication lists were very satisfied with them.ConclusionsIn this randomized controlled trial, patients who received illustrated, plain-language medication lists demonstrated significantly greater understanding of their medication regimen. Such tools have the potential to improve medication use and chronic disease control, as well as reduce health disparities-although this requires further study.
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