Medication Label Summit Panel Discussion Melissa Ngo, PharmD, BCACP Community Pharmacy Supervisor

UW Health Pharmacy Enterprise University Hospital American Family Children’s Hospital Comprehensive Cancer Center Clinics and Surgical Centers The American Center Rehabilitation Hospital SwedishAmerican Hospital Comprehensive Practice Model Oncology Surgery Transplant Critical Care Neuroscience Emergency Medicine Pediatrics Cardiology Internal Medicine Nutrition Support Community Pharmacy Network Chartwell Home Infusion Medication Order Perfection Interdisciplinary Patient Care Rounds Specialty Pharmacy Program Medication Adherence Programs Meds to Beds Resuscitation Teams Operations and Drug Distribution Medication Access and Prior Auth. Programs Clinic Pharmacists (Specialty and Primary Care) Post Discharge Medication Management Discharge Medication Services Tech Check Tech Anticoagulation Stewardship Antimicrobial Stewardship Infusion Services Medication Reconciliation Patient and Provider Education Layered Learning Model Residency Training Programs System Integration Drug Policy Program Med Safety Financial Stewardship Informatics and Analytics Supply Chain Integrity Pharmaceutical Research Center Regional Partnerships Nuclear Pharmacy PBM Program Technicians – Pharmacists – Professional Support Staff

Community Pharmacies 14 Dispensing Locations in Madison, WI Specialty & Mail Service UW Hospital

UW Health Strategic Goals UW Health pharmacy has a vested interest in our patient’s wellbeing since we are part of an Accountable Care Organization

Challenges with Previous Label No separation of information between medication name and directions; Manufacturer of medication in between medication name and directions Where label formatting originated Empty space available on less critical area of label Distance between prescription number and pharmacy phone number Text not aligned and different directions

Patient Misunderstandings The Importance of Standards Patient with poor eyesight misread her oxycodone label Written as ”Take 1-2 tablets…” Patient took 12 tablets Patient did not take antibiotic appropriately Written as “Take 1 tablet by mouth twice daily” Patient took 2 tablets at the same time everyday causing him to not get a consistent amount of medication

New Label Format Directions moved to the top of the text box Increased white space between directions and medication name Some non-critical information moved to open space in yellow Prescription number and pharmacy phone number are directly by each other Less critical information aligned and moved to the side

Challenges of Implementation Label stock Had to work within the confines of current label format Pharmacy software Pre-built quick codes for medication directions spell out number and use words like “once” Unable to modify size/text of pre-populated caution statements Label reformatting needed to be done in a non-user friendly program

Patient Experience Pros: Con: Directions are clearer and stand out Easier to request refills over the phone because prescription number and pharmacy phone number are close together and clear Con: The medication name does not stand out

Key Takeaways and Next Steps Challenging when software is limiting, but creativity can help achieve small changes Label reformatting is just Phase 1 Phase 2 will include manually changing preformatted directions Spelled out numbers will change to digits in quick codes (i.e. “one” to “1”) Directions for frequency of use will be more specific (i.e. “twice daily” to “every 12 hours”) Change hard for staff

Asssessment Question What changes can improve readability of a label for a patient/customer? Increase font size of critical information Increase white space Remove non-required information All of the above

Assessment Question What changes can improve readability of a label for a patient/customer? Increase font size of critical information Increase white space Remove non-required information All of the above