Many Patients Don't Understand Prescription Medicine Labels

Prescription drug instructions

When Michael Wolf paged though dusty, yellowing pharmacists' logs from the 1890s at the Smithsonian National Museum of American History, he found the following entry about a druggist's encounter with a confused patient: "Shake well," a patient apparently read out loud to the pharmacist from his prescription bottle label. "Does that mean I shake myself."

It sounds like the punch line of a bad joke, but it wasn't. And the confusion experienced by that patient more than a century ago hasn't changed much.

Many people still don't fully understand the seemingly simple label instructions on their prescription medication, according to a new study of low-income patients by Wolf, Ph.D., assistant professor of medicine at Northwestern University's Feinberg School of Medicine. The study was published Nov. 29 online in Annals of Internal Medicine (www.annals.org). Wolf is presenting a position piece on how to improve those labels Nov. 29 at the American College of Physicians Foundation conference in Washington, D.C.

Wolf found that nearly half of the patients in the study misinterpreted at least one or more out of the five prescription labels they were shown. Patients with low literacy made the most mistakes and frequently were unable to grasp four out of five label instructions. But even people with a high-school education and higher had problems.

"We came at this from a health literacy perspective, but we found it was a problem with many people in general," said Wolf, director of Northwestern's new Health Literacy and Learning Program, which aims to improve patients' ability to understand and act on health information. "It was surprising how prevalent mistakes were regardless of an individual's literacy level. Just being able to read the label doesn't mean you will