Karel van der Waarde

“Icons and information about medicines”

Situation: Information about medicines is an absolute necessity for patients, healthcare professionals, and carers. Without information, it is impossible to consider the benefits of a medicine, to use it effectively, and to dispose of it safely. Relevant information about medicines is notoriously hard to find, difficult to read and interpret, and often problematic to use. Visuals, and especially pictograms, are often suggested, designed, and used to enable people to act appropriately.

Question: In which situations and for which actions is there evidence that pictograms have benefits for patients? In other words: ‘are we really sure that pictograms support the safe and effective use of medicines’?

Approach: Three different approaches are used. The laws, guidelines, and regulations about medicines were checked to find out what kinds of pictograms are allowed. The second approach is a comparison of some collections of pictograms that are used in practice and appear on packaging. And the third approach is an analysis of seven peer reviewed and published structured reviews.

Results: The results of the inquiry shows that the regulations assume that pictograms are beneficial and allow for their use in information about medicines. However, pictograms are very rarely approved because they can be incorrectly interpreted. Criteria to approve pictograms are missing. The collections of pictograms show that designers believe that the production of even more pictograms is beneficial. There are however no systematic ways to select and evaluate pictograms to determine if they are suitable in a specific context. It is difficult and time consuming to choose pictograms and there is little support available. The comparison of the systematic reviews indicate that these reviews are very seriously flawed. Many articles do not show the pictograms, and this makes it impossible to evaluate an experimental study. The visual qualities and contexts of included studies varies so substantially that they are impossible to relate on a single scale.

Conclusion: The legislation, practice, and literature show that pictograms are used to inform people about medicines. There are some indications that pictograms are effective in some limited ways in some contexts. However, these three sources usually grossly overestimate the effects and benefits of pictograms.

In order to benefit patients, it is necessary to increase the use of visual information from a limited focus on pictograms to all visuals. This visual information must be integrated into an information strategy that combines both paper and digital resources. Visuals need to be accompanied by text, and clearly focus on a single activity. The main conclusion is that information about medicines needs to be developed in co-operation with people who use medicines in specific contexts.

Biography
Dr Karel van der Waarde studied graphic design in the Netherlands (BA) and in the UK (MA & PhD). He combines a commercial Graphic Design – Research consultancy in Belgium (Designing and testing information about medicines), teaching (BA, MA, and PhD level), and research (visual argumentation & reflective practice). See: www.graphicdesign-research.com