Differences in Participant Recall and Preference Based on Patient Medication Information Format

Abstract

Patient medication information (PMI) is currently not meeting patients’ needs, especially those with low health literacy. Studies suggest that adding relevant images to otherwise textual PMI as well as video presentation may be preferred and beneficial to this cohort in terms of information recall. To investigate this, three PMI formats were created for a fictitious medication, Ellistrum. The FDA-Like PMI format was based on an FDA PMI prototype. The other two PMI formats, Picture-Enhanced and Video, were developed using recommended plain language and graphical design principles. Aside from one oversight, the three formats did not differ in content. Participants (n = 584) with below functional health literacy were recruited from Amazon Mechanical Turk, an Internet crowdsourcing market place. They were randomized to one of the three formats and then responded to survey items meant to measure their recall of the information presented. Subsequently, participants were shown all three formats and asked which they would prefer to receive from their pharmacy electronically as well as what they liked and disliked about each format. Average recall scores (± SD) were 6.6/10 (± 1.9), 7.1/10 (± 2.0), and 7.0/10 (± 2.0) for the FDA-Like, Picture-Enhanced, and Video PMI formats, respectively. Transformed ANOVA showed a statistically significant difference in recall scores across the three groups (F(2,581) = 3.715, p = 0.025), and Scheffe post-hoc test determined that this difference was between the FDA-Like and Picture-Enhanced format groups (p = 0.039). Among the 429 participants who indicated preference for only one format, the number who preferred the FDA-Like (n = 170, 29.1%), Picture-Enhanced (n = 153, 26.2%), and Video Format (n = 106, 18.2%) was statistically significantly different (Χ2(2) = 15.37, p < 0.001). The remaining participants indicated preferring some combination of formats (n = 137, 23.5%) or having no preference (n =18, 3.1%). In conclusion, this study found that participant recall was higher when relevant images and other design elements were added to otherwise plain, textual PMI. Future studies should further explore the benefits of incorporating pictures, video, and other design elements into PMI in terms of participant recall, comprehension, and preference.