A pictogram, also called a pictogramme, pictograph, or simply picto and in computer usage an icon, is a graphic symbol that conveys its me...
A pictogram, also called a pictogramme, pictograph, or simply picto and in computer usage an icon, is a graphic symbol that conveys its meaning through its pictorial resemblance to a physical object. In Pharmacy, pictograms are images representing proper ways to take or store medications, precautions, or other important information about a medication that a healthcare provider should provide to his or her patient. It is available for use by health care professionals and others to reinforce printed or oral instructions.
We all know that pictures are frequently considered as a part of universal language and it is often assumed that they can be recognised with ease by all and can convey meaning with little or no dependence on language or cultural background. However, cross-cultural projective testing has indicated that pictures may not necessarily always provide equivalent concepts to all groups. Several studies have documented the importance of country-specific, culturally appropriate pictorial material to relay information, especially to illiterate populations. In the practice of pharmacy, the objective of using pictograms is to convey comprehensively all medication instructions in an understandable manner to the patient. Improved compliance with medication is the desired outcome. Proper guidelines should be followed while designing pictograms to make them more and easily understandable by the patients.
Guidelines to design pictograms:
- Collaborate with the target population
- Use familiar objects and symbols
- Design simple and realistic pictures with limited content
- Use the whole body image
- Use a multiple-stage picture with caution
- Use abstract symbols, symbols depicting motion and symbols conveying perspective with caution
- Use background space appropriately
- Use appropriate colour
- Use the appropriate size and magnification
- Pre-test new pictograms in the target population
Proper evaluation should be done after designing the pictograms to avoid misinterpretation in the coming future. Proper study should be done before designing the pictograms and the pharmacist, who is the health professional most intimately involved with the patient’s therapy and who has the responsibility of educating and counselling patients to optimise compliance, must be involved while designing the pictograms. If necessary, other professionals such as graphic artists may be consulted for ideas and for refining the final image. One of the main strategies to minimise problems when designing pictograms is to identify the target population and to involve that population at all stages of the design and evaluation process. Concepts that patients in Britain may easily understand may be incomprehensible to someone living in a rural community in South Africa. In the less literate person, interpretation is often literal and is related to actual daily occurrences, for eg, the presence of a moon and stars indicating that medication is to be taken at night may seem obvious to most readers, but to some patients, who do not see the moon or stars on a particular night because of clouds, or are asleep when the moon rises, this is meaningless and they will not take their medicine. Direct, concrete instructions, eg, “take three times a day” or “instil drops in the ear,” are more easily depicted, whereas those representing more abstract concepts, such as “this medicine may make you drowsy” or “take the medicine until it is finished,” have been much less successful.
Pictograms should always be used in combination with verbal reinforcement as only then the desired level of detail required for proper comprehension may be achieved. Health professionals using pictograms should therefore be trained in their use to establish communication between patients and pharmacists. Most health professionals are enthusiasts about implementing pictograms in pharmacies. However, some of them have suggested that extra time will be required to explain the pictogram labels. Research has not always shown pictograms to be beneficial. This may be due to poor use of pictograms which were poorly designed and, therefore, misunderstood, due to inadequate research into the initial design process, and partially due to the inappropriate use of pictograms by untrained health professionals. Despite this negative aspect, well-designed, comprehensively tested and appropriately used pictograms can still be a valuable aid in the counselling process.
References:
- Dowse R. and Ehlers M. S. (1998). Pictograms in pharmacy. Int. J. of Pharm. Pract. Pp 109-115.
- URL-1: https://www.usp.org/health-quality-safety/usp-pictograms
- URL-3: https://en.wikipedia.org/wiki/Pictogram
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