(T1030-06-34) Improving Patient Understanding of Prescription Medications Using Science Communication Strategies

Purpose: As many as half of all people in the United States fill a prescription each month, and the pharmaceutical industry at large is responsible for ensuring these patients are provided with the pertinent information about these medications. Many of the ways this information is presented does not follow established science communication techniques and fall trap to the “Deficit Model” which assumes the expert has the information that simply needs to be transferred to layperson in the way the experts have been trained and then the layperson will change their attitudes and behavior. Expert jargon and lack of engaging communication can lead to frustration and confusion that contributes to issues such as poor patient compliance. A pilot program was run to combine art and narrative through cartoons printed on prescription baggies to determine if this could increase patient engagement and understanding of various aspects of prescription medications.

Methods: An anonymous survey was sent to members of the general population through social media outlets to first determine the pharmaceutical topics they found most confusing and were searching for clarity on, with the option to choose up to 3 topics from a list of 10 plus a fill-in option. From those responses, four topics were selected: medication safety, causes of side effects, ingredients, and dosing instructions. We collaborated with 4 artists to develop each topic into 3 x 7” informational cartoons printed as stickers and adhered to pharmaceutical prescription bags. The bags were used by Cottonwood Compounding, a pharmacy in Salt Lake City, UT, for all prescriptions given out for the duration of the pilot program. A postage pre-paid feedback survey was included in the bags. A website was also created, Decode-Rx.org, that showcases each cartoon alongside more detailed information on the topic and links to trustworthy resources. 3 of the 4 topics were also extended into Lifeology courses, which present further information through flashcard-style storytelling, and can be reached through the Decode-Rx website. All of the content was generated following established science communication principles. The feedback forms, website traffic, comments from those in the industry, and pharmacist’s comments, were used to evaluate the effectiveness of the program.

Results: 45 responses were received from the initial survey from participants ranging in age from 24 – 91. 18% of the survey participants worked in the health care industry, although their responses mapped similar to everyone else. Side effects was the most popular topic of interest, with a quarter of participants requesting information on this topic. After designs were finalized, approximately 400 stickered bags were sent out over the course of 2 months. Website analytics indicated that roughly 25% of those who received these bags visited the website, 70% of whom explored beyond the home page. Additionally, in comparing the site traffic between Decode-Rx and Lifeology, similar visitation profiles are observed between the two sites. This indicates that visitors to the main website wanted to explore the additional content. The feedback survey response rate was low at 2%, but close to expected return rate of 5-8% for this type of feedback mechanism. The responses were highly positive, with comments such as “Definitely something I would pay attention to more.” and “I think your cartoon should be given out to everyone filling out a prescription.” Kevin Witzenman, the pharmacist at Cottonwood Compounding, found the project effective and said his patients enjoyed receiving the bags. He also suggested it could be helpful in reverse: helping develop strategies to explain concepts that he finds the trickiest to convey to patients.

Conclusion: The feedback and engagement from this pilot program demonstrates the effectiveness of presenting technical pharmaceutical information through proven communication strategies. Using prescription bags as a communication tool is a way to implant science communication into an already preexisting system with direct contact to people in need of the information. Larger and more in depth studies would be needed to better quantitate how much patient understanding of these topics is improved, and whether if could lead to improved patient compliance as a result. The responses received in this study show that people do want the correct information and appreciate the manner in which it was presented through this project.

References: 1. Crescent B. Martin, Craig M. Hales, Qiuping Gu, Cynthia L. Ogden. Prescription Drug Use in the United States, 2015–2016. NCHS Data Brief, 334, May 2019.
2. Simis MJ, Madden H, Cacciatore MA, Yeo SK. The lure of rationality: Why does the deficit model persist in science communication? Public Underst Sci. 2016 May;25(4):400-14.
3. Sawant R, Sansgiry S. Communicating risk of medication side-effects: role of communication format on risk perception. Pharm Pract (Granada). 2018 Apr-Jun;16(2):1174.
4. Büchter RB, Fechtelpeter D, Knelangen M, Ehrlich M, Waltering A. Words or numbers? Communicating risk of adverse effects in written consumer health information: a systematic review and meta-analysis. BMC Med Inform Decis Mak. 2014 Aug 26;14:76.
5. Knapp P, Raynor DK, Berry DC. Comparison of two methods of presenting risk information to patients about the side effects of medicines. Qual Saf Health Care. 2004 Jun;13(3):176-80.

Acknowledgments: The authors would like to thank the following: Association of Science Communicators, Sigma Xi, and the Burroughs Welcome Fund for funding this project; Manasi Pethe, Ricky Vigil, Danielle Mariano, Sam Madeley, and Pooja Gupta for contributing the art; Paige Jarreau and Lifeology for funding artists, partnership in design, artist recruitment, and hosting the extended courses; Utah Arts Alliance for aid in recruiting artists; Sky Hatter for graphic design assistance; Kevin Witzenman and Cottonwood Compounding for distribution

The 4 sticker designs used for this pilot program



The full Lifeology course developed to help explain side effects and safety of prescription medications, the topic most people want to know more about!



(Left) Results from the initial survey conducting showing safety and side effects as the main topics that people are interesting in understanding better. (Right) Comparison of the Decode-RX and Lifeology site traffic by day, illustrating that people directed to the website from the stickers are exploring the full content.