The evaluation of pharmaceutical pictograms in a low-literate South African population

Patient Educ Couns. 2001 Nov;45(2):87-99. doi: 10.1016/s0738-3991(00)00197-x.


An inability to read and understand written medication instructions may be a major contributory factor to non-compliance in certain patient populations, particularly in countries with a high illiteracy rate such as South Africa. Twenty three pictograms from the USP-DI and a corresponding set of 23 locally developed, culturally sensitive pictograms for conveying medication instructions were evaluated in 46 Xhosa respondents who had attended school for a maximum of 7 years. Respondents were tested for their interpretation of all 46 pictograms at the first interview and again 3 weeks later. The correct meaning of each pictogram was explained at the end of the first interview. Preference for either the Local or USP pictograms was determined. At the follow-up interview, 20 of the Local pictograms complied with the ANSI criterion of >/=85% comprehension, compared with 11 of the USP pictograms. Respondents indicated an overwhelming preference for the Local pictograms.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude to Health
  • Audiovisual Aids / standards*
  • Color
  • Educational Status*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic / methods*
  • Patient Education as Topic / standards
  • Program Evaluation
  • Self Administration* / methods
  • South Africa
  • Surveys and Questionnaires