Strategies to optimize comprehension of numerical medication instructions: A systematic review and concept map.
Review
Overview
abstract
OBJECTIVE: To develop evidence-based recommendations for improving comprehension of quantitative medication instructions. METHODS: This 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. RESULTS: Twenty-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. CONCLUSIONS: Visualized 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 IMPLICATIONS: Practitioners should use visualizations for liquid medication instructions and time period-based instructions to improve outcomes.
