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Prescription Instructions Confuse Even Educated Patients

   March 02, 2011

For example, instead of writing "every 12 hours," and "twice a day," instructions would read, 8 a.m. and 6 p.m. One prescription might read, "take 2 tablets by mouth every 12 hours," while a second prescription might read, "take 2 tablets by mouth in morning and evening." That's the same instruction, but may be interpreted to mean the drugs must be taken at different times.

"Our findings demonstrate that most patients may self-administer multidrug regimens more times a day than necessary and that those with limited literacy are at greater risk," the authors wrote.  "This increased complexity, at the every least, translates to taking medication too often each day, leading to substantial interference with patients' lives. As a result, doses may be frequently missed or incorrectly administered."

The researchers added that their report, the first of its kind, "offers "compelling, preliminary evidence of the need to help all patients more clearly understand, organize and simplify their medication regimens."

The researchers gave two reasons why the problem could be a lot worse than their experiment demonstrated. First, nearly two thirds of their participants had a household income of more than $50,000 a year and nearly two-thirds of the volunteers also had a college degree, and as such were considered highly educated.

Second, while these volunteers, whose average age was 63, were vexed trying to organize seven medications, patients over age 65 on average grapple with 20 prescriptions per year. Other over-the-counter medications could confuse the schedule further.  "Our findings should be viewed as the best case scenario, as more socioeconomically disadvantaged patients are more likely to have limited health literacy and face even greater difficulty in organizing and dosing complex medication regimens," they wrote.

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