Explicit and Standardized Prescription Medicine Instructions

To improve patients' understanding, and possibly reduce errors while improving adherence, AHRQ grantee Michael Wolf, Ph.D, and colleagues developed and tested a set of explicit, standardized instructions for taking pills. The instructions follow the Universal Medication Schedule (UMS), which simplifies complex medicine regimens by using standard time periods for administration (morning, noon, evening, and bedtime). See below for instructions, along with translations into five languages.

Wolf and colleagues developed these instructions in response to research that has shown that more explicit prescription medicine instructions are better understood than instructions that are vague or require an individual to calculate when to take a medicine. Simplification and standardization were also goals of the new instructions. Studies have shown that errors are more likely with more complex regimens. Research has also shown that clinicians write instructions in many different ways, which in turn are transmitted by electronic health systems that support such variation to pharmacies. Consistent instructions could reduce confusion and help patients more safely use multi-drug regimens.

The California Endowment funded the translation of the set of explicit standardized instructions into Chinese, Korean, Russian, Spanish, and Vietnamese. Translated instructions were tested with speakers of those languages who had limited English proficiency. While every effort was made to ensure accuracy and reliability of these translations, each pharmacy and pharmacist should confirm the validity and the medical appropriateness of any given translation for a particular patient before using it for the patient's drug label.

For more information about the explicit, standardized prescription medicine, contact Dr. Michael Wolf at mswolf@northwestern.edu.

For more information on the translation of the instructions to other languages, contact Dr. Stacy Bailey at scbailey@email.unc.edu.

For more information about the AHRQ-funded trial of patient-centered labels that used these instructions, view the article, "Rationale and design of a randomized trial to evaluate an evidence-based prescription drug label on actual medication use." The abstract is available from http://www.ncbi.nlm.nih.gov/pubmed/20647058.