Improving drug therapy safety through pictograms: opportunities, limitations and future prospects—a survey of healthcare professionals

OBJECTIVES: Patient safety in drug therapy depends on clear, rapidly comprehensible medication information in routine care. Pictograms depicting selected drug-related problems (DRPs) may support risk management and help healthcare workers reduce medication errors. To be effective, information provided by such pictograms should be intuitive and accessible to the entire healthcare workforce, requiring targeted change management strategies within healthcare professions. METHODS: We performed a prospective cross-sectional online survey asking for (1) existing measures and strategies to communicate DRPs, (2) assessments of general benefits and potential of pictograms within routine practice, (3) prioritised DRP categories for pictogram development, (4) intuitive recognisability and comparative evaluation of newly developed pictograms, and (5) ideas for optimising pictograms. All healthcare professions of a university hospital (1451 beds, 61 (poly)clinics, >6000 employees) were invited to participate. RESULTS: In total, n=193 participants took part in the survey (median age 38 years, 67% women; 28% physicians, 32% nurses, 22% other healthcare professionals; median total work experience 14 years). (1) Pictograms or (visual) warning labels were already actively used by 43% of participants. (2) 83% of the participants deemed pictograms as beneficial. Participants mentioned the main advantages were 'faster understanding' (81%) and 'simplified communication across language barriers' (70%). (3) drug-drug interactions' was rated most important overall (82%). (4) Newly developed pictograms achieved the highest correct interpretation rate for 'medication without indication' (90%). (5) The main measure for optimisation was using 'pictograms together with signal words' (56%). CONCLUSIONS: Healthcare professionals perceive pictograms as beneficial for DRP communication, yet the risk of misinterpretation is high. Therefore, newly developed pictograms require further optimisation and evaluation before they can be applied in clinical routine. Embedding such pictograms as tools within risk management and change management frameworks may improve DRP communication, help the healthcare workforce prevent medication errors and enhance patient safety.