1. DRUG LABELS SAVING LIVES OR KILLING PATIENTS? READ, GET HELP, OR ASK This slide show plays with automatic timing. Click on Any Slide To Gain Control of Timing.

2. WHAT CAN GO WRONG ? DRUG LABELS CONTAIN IMPORTANT INFORMATION THAT CAN BE MISUNDERSTOOD A PRESCRIPTION DRUG WARNING FOR ALL PEOPLE ~ ALL AGE GROUPS: ~ STRONG ENOUGH TO SAVE LIVES ~ POWERFUL ENOUGH TO KILL

3. GOOD DRUGS ~ BAD CHOICES TOO MANY ~ TOO SOON ~ TOO OFTEN ~ T0O FEW TOO LATE ~ TOO OLD ~ TOO STRONG ~ TOO WEAK

4. THE RIGHT DRUG IN THE WRONG DOSE IS DANGEROUS: TAKE TWO PILLS TWICE DAILY," TO MANY PATIENTS MEANS "TAKE TWO PILLS A DAY," RATHER THAN THE INTENDED INSTRUCTION OF TAKING A DAILY TOTAL OF FOUR PILLS

5. GOOD DRUGS ~ BAD CHOICES THE RIGHT DRUGS AT THE WRONG TIME CAN BE DANGEROUS

6. GOOD DRUGS ~ BAD CHOICES BAD COMBINATIONS CAN MAKE GOOD DRUGS DO BAD THINGS PRESCRIPTION DRUGS CAN INTERACT WITH OTHER PRESCRIPTION DRUGS, NON PRESCRIPTION DRUGS OR “VITAMIN” SUPPLEMENTS WITH SERIOUS RESULTS

7. BAD DRUGS ~ GOOD CHOICES DON’T TAKE IF ~ EXPIRED ~ NOT FOR YOU ~ WRONG COLOR

8. BAD DRUGS ~ GOOD CHOICES DECAYING OVER TIME ~ UNSTABLE AFTER EXPIRATION

9. BAD DRUGS ~ GOOD CHOICES OTHER PEOPLES DRUGS MAY NOT BE RIGHT FOR YOU

10. BAD DRUGS ~ GOOD CHOICES PHARMACY ERRORS HAPPEN: DON’T TAKE DRUGS THAT DON’T LOOK RIGHT !

11. QUESTIONS TO ASK AT THE PHARMACY HOW & WHEN DO I TAKE THESE ? ~ SPECIAL HANDLING? ~ SIDE EFFECTS ? WILL I SUNBURN FASTER ? ~ CAN I WORK OR DRIVE ? ~ FOODS TO AVOID ?

12. QUESTIONS TO ASK AT THE PHARMACY WHAT DO THESE INSTRUCTIONS MEAN ??? SIG ~ PR ~ Topical ~ BID ~ QID PO ~ PRN ~ QS ~ HS ~ QAM ~ TID

13. QUESTIONS TO ASK AT THE PHARMACY ANY SPECIAL TEMPERATURE NEEDED FOR STORAGE ?

15. CAN’T READ ? NOT SURE ? ASK FOR HELP !

16. WATCH CONSUMER REPORTS VIDEO FROM YOUTUBE.COM NOTE: EXTERNAL CONTENT MUST BE ENABLED, IF NO PLAY BUTTON, WAIT 10-15 SECONDS, CLICK PLAY BUTTON TO VIEW VIDEO

17. PUBLIC HEALTH STATISTICS ABOUT HALF OF AMERICANS HAVE DIFFICULTY READING AND USING HEALTH INFORMATION; POOR HEALTH LITERACY IS A CRITICAL BARRIER TO ADEQUATE CARE. 1 ELDERLY PATIENTS HAVE PARTICULAR DIFFICULTY READING AND UNDERSTANDING DRUG LABELING. 2 A SURVEY OF GERIATRIC PATIENTS FOUND THAT THEY FREQUENTLY DID NOT UNDERSTAND HOW TO TIME THEIR DOSING IN RELATION TO MEALS 3 IN YOUNGER POPULATIONS, AN EVALUATION OF PARENTS’ ABILITY TO COMPREHEND DRUG LABELS FOR THEIR CHILDREN AND CALCULATE APPROPRIATE DOSES FOUND THAT …56 PERCENT WERE UNABLE TO CALCULATE APPROPRIATE DOSES OF COUGH SYRUP… 4 THE INTERNATIONAL INSTITUTE OF MEDICINE (IOM) ESTIMATES THAT 1.5 MILLION MEDICATION ERRORS OCCUR ANNUALLY IN THE UNITED STATES. A LARGE PROPORTION OF THESE OCCUR IN THE OUTPATIENT SETTING, GENERATING COSTS OF MORE THAN $3.5 BILLION. 5

18. REFERENCES 1. INSTITUTE OF MEDICINE, HEALTH LITERACY: A PRESCRIPTION TO END CONFUSION, WASHINGTON: NATIONAL ACADEMIES PRESS, 2004 REFERENCE 2. R.W. MORRELL, D.C. PARK, AND L.W. POON, “EFFECTS OF LABELING TECHNIQUES ON MEMORY AND COMPREHENSION OF PRESCRIPTION INFORMATION IN YOUNG AND OLD ADULTS,” JOURNAL OF GERONTOLOGY 45, NO. 4 (1990): P166–P172 3. G. ZUCCOLLO AND H. LIDDELL, “THE ELDERLY AND THE MEDICATION LABEL: DOING IT BETTER,” AGEING 14, NO. 6 (1985): 371–376 4. V.L. PATEL, T. BRANCH, AND J.F. AROCHA, “ERRORS IN INTERPRETING QUANTITIES AS PROCEDURES: THE CASE OF PHARMACEUTICAL LABELS,” INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS 65, NO. 3 (2002): 193–211. 5. PHILIP ASPDEN, JULIE A. WOLCOTT, J. LYLE BOOTMAN, LINDA R. CRONENWETT,ASPDEN ET AL., EDS., PREVENTING MEDICATION ERRORS, NATIONAL ACADEMIES PRESS, 2015.

19. THE END LONN DUGAN, STUDENT HEALTH CARE COMMUNICATION SPRING 2015 ALS 3040:902