Prescription Labels Often Misunderstood

In study, many took "two tablets twice a day" to mean two pills in total

FRIDAY, Dec. 1, 2006 (HealthDay News) -- Many Americans, including those with college degrees, have trouble interpreting the instructions on prescription drug labels, a new study finds.

Indeed, only 34.7 percent of the people with lower literacy, grade level or below, interviewed for the study could determine the number of pills to take daily when faced with "take two tablets by mouth twice daily," according to the study report in Annals of Internal Medicine.

And 9 percent of all those interviewed had trouble with the instruction, "take one tablet by mouth once each day."

The problem is most common with the "two tablets twice daily," noted researcher Michael S. Wolf, assistant professor of medicine at Northwestern University's Feinberg School of Medicine. That is often misinterpreted to mean "two tablets a day," he said. But the number of misinterpretations rises with the amount of numbers included in the instructions, Wolf said. So, "take one teaspoon twice a day for seven days" is especially confusing, for example, he noted.

It's an important issue because more and more Americans are taking more and more medications, said lead researcher Terry C. Davis, professor of medicine and pediatrics at Louisiana State University Health Sciences Center in Shreveport.

"The topic resonates because most people are taking some medication and taking them safely is important," she said.

Important enough for the American Academy of Physicians Foundation to appoint a new advisory committee, headed by Wolf, to come up with better ways of making sure that people know how much of a drug they should be taking, and when.

"We're working to push for policy change, and we expect to report this month or early in January," Wolf said.

The problem can start in the doctor's office, Davis said. "Most doctors don't give any instructions on how to take the medicine" that they write prescriptions for, she said. "Doctors can be more precise -- saying when a drug should be taken, how many times a day and for how long," she said.

This type of detailed information can be included if a patient asks for it, either in the physician's office or at the pharmacy, Davis said.

But there's a more basic problem, Wolf said. "We may need more explicit instructions," he said. "The current system is very bad at providing information on prescription drugs. Instructions can vary not only by pharmacy but also by physician."

The committee probably will recommend "some regulatory oversight to standardize dosage, of a kind we've never had before," Wolf said.

The issue of "how we can confuse patients less" about the drugs they take is of growing importance, Wolf said. He estimated that perhaps 500,000 adverse events occur each year in this country because people misread their drug instruction.

More information

There's more on prescription drugs at the U.S. Food and Drug Administration.

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