Improved Label and Liver Warning for Nonprescription Acetaminophen Products.

OBJECTIVE: To compare consumer preferences for a revised and current acetaminophen over-the-counter "Drug Facts" labels (ODFL) on warnings and self-reported correct intended action following signs of overdose. METHODS: Adults visiting a community center were randomly assigned to revised or current ODFLs using previously reported label comprehension methodology. RESULTS: Participant (N = 110) ratings for both ODFLs were comparable for ease of finding and understanding information. In response to an emergent overdose scenario, the proportion reporting the correct intended action using the revised ODFL was significantly greater than the proportion using the current ODFL (91% [97.5% CI, 0.82-0.99] vs. 76% [97.5% CI, 0.64-0.89]). In side-by-side comparisons, the revised ODFL was superior for overall consumer preference, usefulness for first-time use, and better overdose-related directions. A revised bottle cap statement also outperformed the current statement used on brand acetaminophen. CONCLUSION: Findings support revision of acetaminophen ODFLs to improve liver damage warnings and to optimize labeling likely to be useful in prevention of and response to overdose.

Performance of a new speech translation device in translating verbal recommendations of medication action plans for patients with diabetes.

BACKGROUND: Language barriers are significant hurdles for chronic disease patients in achieving self-management goals of therapy, particularly in settings where practitioners have limited nonprimary language skills, and in-person translators may not always be available. S-MINDS© (Speaking Multilingual Interactive Natural Dialog System), a concept-based speech translation approach developed by Fluential Inc., can be applied to bridge the technologic gaps that limit the complexity and length of utterances that can be recognized and translated by devices and has the potential to broaden access to translation services in the clinical settings. METHODS: The prototype translation system was evaluated prospectively for accuracy and patient satisfaction in underserved Spanish-speaking patients with diabetes and limited English proficiency and was compared with other commercial systems for robustness against degradation of translation due to ambient noise and speech patterns. RESULTS: Accuracy related to translating the English-Spanish-English communication string from practitioner to device to patient to device to practitioner was high (97-100%). Patient satisfaction was high (means of 4.7-4.9 over four domains on a 5-point Likert scale). The device outperformed three other commercial speech translation systems in terms of accuracy during fast speech utterances, under quiet and noisy fluent speech conditions, and when challenged with various speech disfluencies (i.e., fillers, false starts, stutters, repairs, and long pauses). CONCLUSIONS: A concept-based English-Spanish speech translation system has been successfully developed in prototype form that can accept long utterances (up to 20 words) with limited to no degradation in accuracy. The functionality of the system is superior to leading commercial speech translation systems.

Comparison of the packaging and labeling of Target ClearRx with conventional prescription drug packaging and labeling.

OBJECTIVE: To compare consumer preferences for Target pharmacy's clearrx packaging and labeling with conventional prescription drug packaging and labeling. DESIGN: Prospective, hands-on comparison of packaging and labeling formats. SETTING: Two suburban shopping malls in northern California in February and March 2006. PARTICIPANTS: Volunteer participants from local communities. INTERVENTIONS: Self-administered questionnaire. Participants were asked to compare ClearRx bottles with conventional cylindrical prescription bottles (both labeled as containing fluoxetine). They also were asked their opinions on three ClearRx bottles (labeled as containing albuterol, amoxicillin, or atenolol) with different color rings corresponding to three fictitious family members. MAIN OUTCOME MEASURES: Consumer preference for ClearRx or conventional packaging and labeling, consumer ability to differentiate between two types of packaging and labeling, consumer perception of safety design, and reasons for consumer preferences. RESULTS: The majority of consumers (85%) preferred ClearRx packaging and labeling over the conventional format (10%; 5% uncertain; P < 0.0005). Consumers described distinct differences between the packaging and labeling formats, citing ClearRx as better designed for safety, easier to read, and having better organized warnings with larger type size. The ClearRx patient information card was rated by the majority of consumers as easy or very easy to access (91%; P < 0.0005), important or very important to retain as a reference during use (94%; P < 0.0005), and helpful for improving medication safety (91% agree or strongly agree; P < 0.0005). Features designed to avoid medication mix-ups (i.e., color rings, large type face for medication name) allowed consumers to easily distinguish among bottles of ClearRx. These findings were consistent across various demographic categories. CONCLUSION: ClearRx represents an important advance in meeting consumer needs for patient-centered designs in prescription packaging and labeling.