Infographics and/or Pictograms and Medication Adherence: A Scoping Review
DOI:
https://doi.org/10.15273/hpj.v3i2.11553Resumo
Introduction: Medication adherence is the act of following medication instructions from a health care provider. Infographics and pictograms are visual science communication tools that have been shown to improve medication adherence. Objective: To synthesize and critically evaluate literature surrounding the use of infographics and pictograms in medication adherence. Methods: We conducted a literature search on PubMed, Ovid MEDLINE, CINAHL, Web of Science, and PsycInfo with the purpose of identifying literature published between the years 2000 and 2022. Primary research articles were included for quantitative analysis if they explored/reported the following topics and/or outcomes: (a) infographics and/or pictograms as the exposure of interest and (b) adherence, comprehension, or health outcomes as the outcome measures. Results: 30 studies were included in the results. Outcome measures assessed included (a) comprehension and understanding of factors surrounding medication adherence, (b) medication adherence, and (c) health outcomes. Our review of the studies showed that 87.5% of studies measuring outcome (a), 78.2% of those measuring outcome (b), and 100% of those measuring outcome (c) found improvements when using infographics or pictograms. Conclusion: Our review supports the use of infographics and pictograms as a means of improving medication adherence among a diverse set of demographics, illnesses, and treatments. Practice Implications: Infographics and pictograms are useful tools to improve medication adherence. When these tools are designed carefully, they increase the accessibility of medication information in a wide range of patient populations.
Referências
Almomani, B. A., Mokhemer, E., Al-Sawalha, N. A., & Momany, S. M. (2018). A novel approach of using educational pharmaceutical pictogram for improving inhaler techniques in patients with asthma. Respiratory Medicine, 143, 103–108. https://doi.org /10.1016/j.rmed.2018.09.004
Arksey, H., & O‘Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
Artmann, A., Rahn, A. C., Köpke, S., Thomalla, G., Heesen, C., & Alegiani, A. C. (2022). Risk communication in acute stroke patients – From qualitative data to a pilot randomised controlled trial. ZEFQ: Journal of Evidence and Quality in Health Care, 169, 19–27. https://doi.org/ 10.1016/j.zefq.2022.01.001
Bengtsson, A., Norberg, M., Ng, N., Carlberg, B., Grönlund, C., Hultdin, J., Lindahl, B., Lindahl, B., Nordin, S., Nyman, E., Wennberg, P., Wester, P., & Näslund, U. (2021). The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: Results from the VIPVIZA randomized clinical trial. American Journal of Preventive Cardiology, 7, Article 100199. https:// doi.org/10.1016/j.ajpc.2021.100199
Bhardwaj, B., Singh, J., & Singh, T. (2022). Impact of patient guidance handouts on outcomes of FESS. Indian Journal of Otolaryngology and Head & Neck Surgery, 74(1), 23–31. https://doi.org/10.1007/s12070-020-02133-z
Braich, P. S., Almeida, D. R., Hollands, S., & Coleman, M. T. (2011). Effects of pictograms in educating 3 distinct low-literacy populations on the use of postoperative cataract medication. Canadian Journal of Ophthalmology, 46(3), 276–281. https://doi.org/10.1016/j.jcjo.2011.05.004
Branda, M. E., Kunneman, M., Meza-Contreras, A. I., Shah, N. D., Hess, E. P., LeBlanc, A., Linderbaum, J. A., Nelson, D. M., Mc Donah, M. R., Sanvick, C., Van Houten, H. K., Coylewright, M., Dick, S. R., Ting, H. H., & Montori, V. M. (2022). Shared decision-making for patients hospitalized with acute myocardial infarction: A randomized trial. Patient Preference and Adherence, 16, 1395–1404. https://doi.org/10.2147/ PPA.S363528
Browne, S. H., Barford, K., Ramela, T., & Dowse, R. (2019). The impact of illustrated side effect information on understanding and sustained retention of antiretroviral side effect knowledge. Research in Social and Administrative Pharmacy, 15(4), 469–473. https://doi.org/10.1016/j.sapharm.2018.05.012
Castro-Caldas, A., Petersson, K. M., Reis, A., Stone-Elander, S., & Ingvar, M. (1998). The illiterate brain. Learning to read and write during childhood influences the functional organization of the adult brain. Brain, 121(6), 1053–1063. https://doi.org/10.1093/brain/121.6.1053
Chan, H.-K., & Hassali, M. A. (2014). Modified labels for long-term medications: Influences on adherence, comprehension and preferences in Malaysia. International Journal of Clinical Pharmacy, 36(5), 904–913. https://doi.org/10.1007/s11096-014-0003-1
Chanzu, A., Wells, M., Vitkin, N., & Nersesian, S. (2023). The importance of iron supplementation in pregnant women: An infographic. Healthy Populations Journal, 3(2), 151-131. https://doi.org/10.15273/hpj.v3i2.11552
Chongpornchai, J., Phornprapa, N., & Sratthaphut, I. (2021). Effectiveness of motion infographic media on the improvement of knowledge and medical adherence in human immunodeficiency virus patients. Indian Journal of Pharmacy, 83(3), 562–568. https://doi.org/10.36468/pharmaceutical-sciences.806
Cramer, J. A., Roy, A., Burrell, A., Fairchild, C. J., Fuldeore, M. J., Ollendorf, D. A., & Wong, P. K. (2008). Medication compliance and persistence: Terminology and definitions. Value in Health, 11(1), 44–47. https://doi.org/10.1111/j.1524-4733.2007.00213.x
Cutler, R. L., Fernandez-Llimos, F., Frommer, M., Benrimoj, C., & Garcia-Cardenas, V. (2018). Economic impact of medication non-adherence by disease groups: A systematic review. BMJ Open, 8(1), Article e016982. https://doi.org/ 10.1136/bmjopen-2017-016982
De Tullio, P. L., Kirking, D. M., Arslanian, C., & Olson, D. E. (1987). Compliance measure development and assessment of theophylline therapy in ambulatory patients. Journal of Clinical Pharmacy and Therapeutics, 12(1), 19–26.
Dowse, R., Barford, K., & Browne, S. H. (2014). Simple, illustrated medicines information improves ARV knowledge and patient self-efficacy in limited literacy South African HIV patients. AIDS Care, 26(11), 1400–1406. https://doi.org/10.1080/09540121.2014.931559
Dowse, R., & Ehlers, M. (2005). Medicine labels incorporating pictograms: Do they influence understanding and adherence? Patient Education and Counseling, 58(1), 63–70. https:// doi.org/10.1016/j.pec.2004.06.012
Ebrahimabadi, M., Rezaei, K., Moini, A., Fournier, A., & Abedi, A. (2019). Infographics or video; Which one is more effective in asthmatic patients‘ health? A randomized clinical trial. Journal of Asthma, 56(12), 1306–1313. https://doi.org/10.1080/02770903.2018.1536143
Galloway, R., & McGuire, J. (1994). Determinants of compliance with iron supplementation: Supplies, side effects, or psychology? Social Science & Medicine, 39(3), 381–390. https://doi.org/10.1016/0277-9536(94)90135-x
Garcia-Aymerich, J., Hernandez, C., Alonso, A., Casas, A., Rodriguez-Roisin, R., Anto, J. M., & Roca, J. (2007). Effects of an integrated care intervention on risk factors of COPD readmission. Respiratory Medicine, 101(7), 1462–1469. https://doi.org/10.1016 /j.rmed.2007.01.012
Hynes, L., Durkin, K., Ewell, T., Lilly, C., Williford, D. N., Ahrabi-Nejad, C., Noel, D., Kothari, V., Skoner, D., & Duncan, C. L. (2022). Pictorial versus written asthma action plans for youth: Initial impact on regimen knowledge, medication adherence, symptom control, and family satisfaction. Journal of Asthma, 59(9), 1885–1898. https://doi.org/10.1080/02770903.2021.1968427
Kalichman, S. C., Cherry, C., Kalichman, M. O., Amaral, C., White, D., Grebler, T., Eaton, L. A., Cruess, D., Detorio, M. A., Caliendo, A. M., & Schinazi, R. F. (2013). Randomized clinical trial of HIV treatment adherence counseling interventions for people living with HIV and limited health literacy. Journal of Acquired Immune Deficiency Syndrome, 63(1), 42–50. https://doi.org/10.1097 /QAI.0b013e318286ce49
Katz, M. G., Kripalani, S., & Weiss, B. D. (2006). Use of pictorial aids in medication instructions: A review of the literature. American Journal of Health-System Pharmacy, 63(23), 2391–2397. https://doi.org/10.2146/ajhp060162
Mansoor, L. E., & Dowse, R. (2006). Medicines information and adherence in HIV/AIDS patients. Journal of Clinical Pharmacy and Therapeutics, 31(1), 7–15. https://doi.org/10.1111/j.1365-2710.2006.00696.x
Martin, L. J., Turnquist, A., Groot, B., Huang, S. Y. M., Kok, E., Thoma, B., & van Merriënboer, J. J. G. (2019). Exploring the role of infographics for summarizing medical literature. Health Professions Education, 5(1), 48–57. https://doi.org/https://doi.org/10.1016/j.hpe.2018.03.005
Maximos, M., Smith, K., Harris, V., McFarlane, T., Blay, J., Hahn, K., & Chang, F. (2021). A randomized controlled trial to assess the influence of a picture-based antiemetic medication calendar on medication-taking behavior in adults receiving chemotherapy. Journal of Oncology Pharmacy Practice, 28(8), 1763–1770. https://doi.org/10.1177/10781552211041680
Merks, P., Świeczkowski, D., Balcerzak, M., Drelich, E., Białoszewska, K., Cwalina, N., Zdanowski, S., Krysiński, J., Gromadzka, G., & Jaguszewski, M. (2019). Patients‘ perspective and usefulness of pictograms in short-term antibiotic therapy – Multicenter, randomized trial. Patient Preference and Adherence, 13, 1667–1676. https://doi.org/10.2147/PPA.S214419
Merks, P., Świeczkowski, D., Balcerzak, M., Religioni, U., Drelich, E., Krysiński, J., Hering, D., & Jaguszewski, M. (2021). Patient counselling service with the use of pictograms as the example of pharmacist intervention to improving compliance and medicine safety. Cardiology Journal, 28(6), 879–886. https://doi.org/10.5603/CJ.a2021.0022
Mohamed, H. F., Allam, M. M., Hamdy, N. A., Ghazy, R. M., & Emara, R. H. (2021). A community pharmacy-based intervention in the matrix of type 2 diabetes mellitus outcomes (CPBI-T2DM): A cluster randomized controlled trial. Clinical Medicine Insights: Endocrinology and Diabetes, 14. https://doi.org/10.1177/11795514211056307
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group. (2009). Preferred Reporting Items for Systematic reviews and Meta-Analyses: The PRISMA statement. PLOS Medicine, 6(7), Article e1000097. https://doi.org/ 10.1371/journal.pmed.1000097
Moin, M., Saadat, S., Rafique, S., Maqsood, A., Lal, A., Vohra, F., Alam, M. K., & Ahmed, N. (2021). Impact of oral health educational interventions on oral hygiene status of children with hearing loss: A randomized controlled trial. BioMed Research International, 2021, Article 5185613. https://doi.org/ 10.1155/2021/5185613
Moon, S. J., Lee, W.-Y., Hwang, J. S., Hong, Y. P., & Morisky, D. E. (2017). Accuracy of a screening tool for medication adherence: A systematic review and meta-analysis of the Morisky Medication Adherence Scale-8. PLOS ONE, 12(11), Article e0187139. https://doi.org/10.1371/journal.pone.0187139
Monroe, A. K., Pena, J. S., Moore, R. D., Riekert, K. A., Eakin, M. N., Kripalani, S., & Chander, G. (2018). Randomized controlled trial of a pictorial aid intervention for medication adherence among HIV-positive patients with comorbid diabetes or hypertension. AIDS Care, 30(2), 199–206. https://doi.org/ 10.1080/09540121.2017.1360993
Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18, Article 143. https:// doi.org/10.1186/s12874-018-0611-x
Nahrisah, P., Somrongthong, R., Viriyautsahakul, N., Viwattanakulvanid, P., & Plianbangchang, S. (2020). Effect of integrated pictorial handbook education and counseling on improving anemia status, knowledge, food intake, and iron tablet compliance among anemic pregnant women in Indonesia: A quasi-experimental study. Journal of Multidisciplinary Healthcare, 13, 43–52. https://doi.org/10.2147/JMDH.S213550
Näslund, U., Ng, N., Lundgren, A., Fhärm, E., Grönlund, C., Johansson, H., Lindahl, B., Lindahl, B., Lindvall, K., Nilsson, S. K., Nordin, M., Nordin, S., Nyman, E., Rocklöv, J., Vanoli, D., Weinehall, L., Wennberg, P., Wester, P., & Norberg, M. (2019). Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): A pragmatic, open-label, randomised controlled trial. The Lancet, 393(10167), 133–142. https://dx.doi.org/ 10.1016/S0140-6736(18)32818-6
Negarandeh, R., Mahmoodi, H., Noktehdan, H., Heshmat, R., & Shakibazadeh, E. (2013). Teach back and pictorial image educational strategies on knowledge about diabetes and medication/dietary adherence among low health literate patients with type 2 diabetes. Primary Care Diabetes, 7(2), 111–118. https://doi.org/10.1016/j.pcd.2012.11.001
Nides, M. A., Tashkin, D. P., Simmons, M. S., Wise, R. A., Li, V. C., & Rand, C. S. (1993). Improving inhaler adherence in a clinical trial through the use of the Nebulizer Chronolog. CHEST, 104(2), 501–507. https://doi.org/10.1378 /chest.104.2.501
Otten, J. J., Cheng, K., & Drewnowski, A. (2015). Infographics and public policy: Using data visualization to convey complex information. Health Affairs, 34(11), 1901–1907. https://doi.org/ 10.1377/hlthaff.2015.0642
Paas, F., van Gog, T., & Sweller, J. (2010). Cognitive load theory: New conceptualizations, specifications, and integrated research perspectives. Educational Psychology Review, 22(2), 115–121. https://doi.org/10.1007/s10648-010-9133-8
Park, M. (2011). Effects of interactive pictorial education on community dwelling older adult‘s self efficacy and knowledge for safe medication. Journal of Korean Academy of Nursing, 41(6), 795–804. https://doi.org/10.4040/jkan.2011.41.6.795
Patiag, M. C., Deveux, S., & Farrar Highfield, M. E. (2020). Do errorless methods improve discharge medication instruction and adherence? Rehabilitation Nursing, 45(6), 358–366. https://doi.org/10.1097/rnj.0000000000000237
Phimarn, W., Ritthiya, L., Rungsoongnoen, R., Pattaradulpithuk, W., & Saramunee, K. (2019). Development and evaluation of a pictogram for Thai patients with low literate skills. Indian Journal of Pharmaceutical Sciences, 81(1), 89–98. https://doi.org/10.4172/pharmaceutical-sciences.1000483
Sacchetti, E., Vita, A., Siracusano, A., & Fleischhacker, W. (2014). Adherence to antipsychotics in schizophrenia. Springer. http://doi.org/10.1007/978-88-470-2679-7
Shenoi, R. S., Rajguru, J. G., Parate, S. R., Ingole, P. D., Khandaitkar, S. R., & Karmarkar, J. S. (2021). Compliance of postoperative instructions following the surgical extraction of impacted lower third molars. Indian Journal of Dental Research, 134(1), 87–91. https:// doi.org/10.4103/ijdr.IJDR_323_20
Sletvold, H., Sagmo, L. A. B., & Torheim, E. A. (2020). Impact of pictograms on medication adherence: A systematic literature review. Patient Education and Counseling, 103(6), 1095–1103. https:// doi.org/10.1016/j.pec.2019.12.018
Tan, X., Patel, I., & Chang, J. (2014). Review of the four item Morisky Medication Adherence Scale (MMAS-4) and eight item Morisky Medication Adherence Scale (MMAS-8). Innovations in Pharmacy, 5(3). https://doi.org/10.24926/iip.v5i3.347
Waffenschmidt, S., Knelangen, M., Sieben, W., Bühn, S., & Pieper, D. (2019). Single screening versus conventional double screening for study selection in systematic reviews: A methodological systematic review. BMC Medical Research Methodology, 19, Article 132. https://doi.org/10.1186/s12874-019-0782-0
Wilby, K., Marra, C. A., da Silva, J. H., Grubisic, M., Harvard, S., & Lynd, L. D. (2011). Randomized controlled trial evaluating pictogram augmentation of HIV medication information. Annals of Pharmacotherapy, 45(11), 1378–1383. https://doi.org/10.1345/aph.1Q091
Yin, H. S., Dreyer, B. P., van Schaick, L., Foltin, G. L., Dinglas, C., & Mendelsohn, A. L. (2008). Randomized controlled trial of a pictogram-based intervention to reduce liquid medication dosing errors and improve adherence among caregivers of young children. JAMA Pediatrics, 162(9), 814–822. https://doi.org/10.1001 /archpedi.162.9.814
