Can improved prescription medication labeling influence adherence to chronic medications? An evaluation of the target pharmacy label


Shrank WH, Gleason PP, Canning C, Walters C, Heaton AH, Jan S, Patrick A, Brookhart MA, Schneeweiss S, Solomon DH, Avorn J, Choudhry NK. Can improved prescription medication labeling influence adherence to chronic medications? An evaluation of the target pharmacy label [Internet]. Journal of General Internal Medicine 2009;24:570-8.

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BACKGROUND: Prescription medication labels contain valuable health information, and better labels may enhance patient adherence to chronic medications. A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve readability and understanding. OBJECTIVE: We evaluated whether the new Target label influenced patient medication adherence. DESIGN AND PATIENTS: Using claims from two large health plans, we identified patients with one of nine chronic diseases who filled prescriptions at Target pharmacies and a matched sample who filled prescriptions at other community pharmacies. MEASUREMENTS: We stratified our cohort into new and prevalent medication users and evaluated the impact of the Target label on medication adherence. We used linear regression and segmented linear regression to evaluate the new-user and prevalent-user analyses, respectively. RESULTS: Our sample included 23,745 Target users and 162,368 matched non-Target pharmacy users. We found no significant change in adherence between new users of medications at Target or other community pharmacies (p = 0.644) after implementing the new label. In prevalent users, we found a 0.0069 percent reduction in level of adherence (95% CI -0.0138-0.0; p < 0.001) and a 0.0007 percent increase in the slope in Target users (the monthly rate of change of adherence) after implementation of the new label (95% CI 0.0001-0.0013; p = 0.001). CONCLUSIONS: We found no changes in adherence of chronic medication in new users, and small and likely clinically unimportant changes in prevalent users after implementation of the new label. While adherence may not be improved with better labeling, evaluation of the effect of labeling on safety and adverse effects is needed.


Shrank, William HGleason, Patrick PCanning, ClaireWalters, CarolHeaton, Alan HJan, SairaPatrick, AmandaBrookhart, M AlanSchneeweiss, SebastianSolomon, Daniel HAvorn, JerryChoudhry, Niteesh KAG-027400/AG/NIA NIH HHS/United StatesK23HL090505-01/HL/NHLBI NIH HHS/United StatesComparative StudyEvaluation StudiesResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tUnited StatesJournal of general internal medicineJ Gen Intern Med. 2009 May;24(5):570-8. Epub 2009 Feb 27.

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