Illegible prescription labels risky, says study

As it turns out, the illegible scrawl your doctor leaves on a prescription pad is only the beginning.

Small print and poor printing on prescription labels handed out by pharmacists may be misread and may lead to errors in taking medication, according to new research by the University of Waterloo and CNIB (Canadian National Institute for the Blind).

The study, published recently in the Canadian Pharmacists Journal, found that labels on prescription medications dispensed by pharmacies do not consistently follow professionally recommended guidelines for legibility.

Researchers asked 45 pharmacies in Kitchener, Waterloo and Cambridge to print a sample prescription label with the patient’s name, drug name and instructions for use. The sample label was then compared with label printing recommendations from pharmaceutical and health organizations, and non-governmental organizations for readability.

The results show that less than half – 44 per cent – of labels met the minimum font size of 12 points. Only half of labels were printed left-justified and few met the recommendations for best use of spacing.

All labels used capital lettering, which is difficult for patients with eye problems to read, instead of the recommended sentence case. More than 90 per cent of labels followed guidelines for font style, contrast, black print and non-glossy paper.

“The research shows that factors such as font size, sentence alignment, case and contrast can impact the readability of the label,” said Professor Carlos H. Rojas-Fernandez from Waterloo’s School of Pharmacy and a Schlegel Research Chair in Geriatric Pharmacotherapy. “We expect that addressing these factors together will improve the accessibility of prescription labels. We need to move from a pharmacy-centred labelling standard, to a patient-centred one.”

By simply following recommended guidelines for font size, use of bolding, justification, sentence case and spacing, researchers expect pharmacies can improve the legibility of their labels without the need for new technologies or larger labels.

“Surprisingly, there are few guidelines and no regulations for the print on prescription labels in Canada,” said Dr. Sue Leat from the School of Optometry and Vision Science. “In Ontario, regulations specify only the content of prescription labels, not how they appear.”

Health professionals and patients are finding label appearance is more important as a significant number of older Canadians experience vision and reading comprehension problems. Patients also prefer to read their own prescriptions to preserve their privacy and independence.

This is the first collaborative research project between the School of Pharmacy and School of Optometry and Vision Science and was funded by the CNIB Baker Fund.

“CNIB helps thousands of Canadians with vision loss maintain their independence,” said Deborah Gold, a study co-author and national director, research and program development at CNIB. “In order to do this and eliminate potentially dangerous medication accidents, we need to raise this issue amongst our colleagues in the pharmacy community.”  

Recommended guidelines considered in this study came from the US Pharmacopeia (USP), the American Society for Consultant Pharmacists, the National Patient Safety Agency in the UK, the American Foundation for the Blind (AFB), the Canadian National Institute for the Blind (CNIB), the Royal National Institute of Blind People (RNIB) in the UK, and the American Council of the Blind (ACB).

The researchers plan to develop a prototype pharmaceutical label and test its readability and accuracy and use a questionnaire to survey pharmacists and patients  (with and without visual impairments).

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Changes afoot at WatCACE

The Waterloo Centre for the Advancement of Co-operative Education (WatCACE) is undergoing a few changes, according to a notice from Associate Provost, Resources Beth Jewkes.

Approval has been received to turn the WatCACE Director position into an ongoing, 60 per cent position instead of a definite term secondment.

Judene Pretti was the successful candidate for this role and will continue as WatCACE director.

“As a result of shifting portfolios in the senior administration at the University, a decision has been made to adjust the reporting structure of WatCACE,” the memo continues. “As of June 1, WatCACE jointly reports to the Executive Director, Co-operative Education & Career Action (CECA) Peggie Jarvie and Associate Vice-President, Academic Mario Coniglio. This arrangement will connect WatCACE to all key stakeholder groups – the students, employers, faculty and staff.

In addition to this reporting structure change, Judene Pretti will be preparing terms of reference for an academic advisory board to formalize the role of the WatCACE Associates group.

Questions can be directed to Beth Jewkes, Mario Coniglio, Peggy Jarvie and Judene Pretti.

“Much thought and discussion has gone into these decisions and we are all excited about the opportunities that lie ahead for WatCACE,” the memo concludes.

WatCACE was established in 2002 and is “designed to capture and share some of the best practices of work-integrated learning through the conduct, facilitation, and application of research, and to increase our understanding of co-op as a pedagogical model and the consequences of the co-op experience for students.”

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Sessions for graduating students next week

Alumni Relations and the Centre for Career Action have partnered to produce a pair of information sessions for graduating students that will be held on Tuesday, July 15 and Wednesday, July 16.

Attendees will learn the facts on securing a job after graduation, hear about job postings for graduating students, expand their knowledge of career and alumni services and events, and learn the benefits of forging relationships with both the Centre for Career Action and Alumni Relations.

The first session on July 15 runs from 11:30 a.m. to 12:20 p.m. in AL116, and the second session is scheduled to take place from 4:30 p.m. to 5:20 p.m. on July 16, also in AL 116.

No registration is necessary for either information session.

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