Influence of visual cues on the medication package on correct dosing

Patients being admitted to hospital due to incorrect dosing of medication is a tragic reality. This is often because package inserts are not consulted for dosage information due to their complexity. The question therefore arises as to whether information such as a visual pictogram on or a textual reference next to the medication package itself, for example, on dosage, can solve the problem of incorrect dosing? To investigate this, participants (N = 518) in a smartphone-based online study were randomly presented with a fictitious medication package containing either 500mg or 1g of paracetamol tablets (factor: dosage) and either no or dosage instructions (control, pictogram or reference; factor: instructions). After the presentation, the participants had to judge, among other things, the maximum single and daily dosage in tablet form, whereby an adjustment of the values was possible after the obligatory consultation of the package insert (PI; factor: PI consultation). Focusing on the relevance of instructions, we found that while in the reference condition participants reported significantly higher dosages compared to the control condition for single and daily dosages (both p’s < .05), compared to the pictogram condition this was only found for the daily dosage (p < .001). Furthermore, instruction only interacted with dosage and time for the daily dosages (both p’s < .05); indicating that in the reference condition compared to the other ones the difference in dosage values was the same before and after PI consultation and the difference for the dosage (500mg and 1g) was more pronounced. In conclusion, it can be said that the reference for the 1g tablets is not ideal, as this group overdoses for the daily dosage. In the control group underdosing is more of a problem. Pictograms provide the most satisfying results, but further research is needed.