Oslo, Norway—Graphic design matters when it comes to helping patients—especially older ones—avoid dangerous medication misuse.

That’s according to an article published recently in the journal Human Factors, which reports that improvements to text size, placement, and color scheme could improve nonprescription drug safety.

The University of Oslo–led study cites past research indicating that inadequate or confusing labeling on packages of OTC medications contributes to many unintentional overdoses, especially among older people.

“Although human factors guidelines for the design of medication packages exist, they do not ensure that patients are receiving consistent information about the medicine they take,” explained lead author Tor Endestad, an associate professor in the Department of Psychology at the University of Oslo. “We were surprised by the variation and inconsistency of the drug information presented on medication packages and decided to manipulate design elements to evaluate whether that could reduce the risk of labeling-related user errors.”

For the study, researchers evaluated user responses to the original packages of generic OTC medication compared with packages that they redesigned in a variety of ways including:
• Reduction in the size of the brand name
• Varied placement of the active ingredient and dosage information
• Several different color schemes.

Sets of computer images showing different packages of the same medications in the original packaging were presented to 84 adults ages 18 to 86. Participants were then asked to indicate within 3 seconds whether the medications contained the same active ingredient.

The process was repeated using images of the redesigned packages.

While error rates were high with the original packaging, they decreased for the redesigned packages from 41% to 8% among younger users and from 68% to 16% among elderly users, according to the results.

Even minor changes—such as highlighting the drug information on a high-contrast background color and positioning it in a dedicated place on the package—helped users identify the medications faster and more accurately, study authors point out.

“Our study found an enormous potential for patients to believe that they are taking two different medications, when in fact they're taking a double dose of the same one,” Endestad emphasizes. “A simple redesign of medication package labels to highlight the name and dosage of the active ingredient on a high-contrast background reduces the probability of user errors.”

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