***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Fifty-five r and omly selected community pharmacy patrons were surveyed regarding their preferences between four different prescription labels . The variables displayed on the four labels were : ( i ) laser printed , ( ii ) dot-matrix printed , ( iii ) glossy surface , and ( iv ) matt surface .  The study population was stratified by age and gender . Statistical analysis of the results indicated a clear preference by all groups for the laser printed labels ( P less than 0.001 ) , and the only other statistically significant finding was the preference for the matt surface ( P less than 0.05 ) of females between the ages of 16 and 39 . The implication s for these differences on label readability are discussed , and recommendations are offered for the use of improved laser technology for computer-generated prescription labels Despite the proven benefits of statins , large numbers of patients meeting guideline criteria for therapy are not receiving these drugs . It has been suggested that over-the-counter ( OTC ) availability of statins would allow more consumers to use statins and achieve cardiovascular risk reduction . However , concerns have been raised as to the consumers ' ability to self-manage hyperlipidemia and use statins safely . The Consumer Use Study of OTC Mevacor ( CUSTOM ) was design ed to define consumer behaviors in the setting of OTC statin availability . The study was conducted in a simulated OTC setting and allowed consumers to purchase once-daily lovastatin 20 mg . The CUSTOM data set includes > 3,300 consumers who evaluated OTC lovastatin for potential purchase at study sites and follow-up information on purchasers for up to 6 months of self-managed therapy . These data have been analyzed to address consumers ' knowledge of their cholesterol concentrations as well as their ability to make OTC use decisions based on their cardiovascular risk , avoid drug-drug interactions , self-manage their cholesterol treatment after deciding to use the OTC product , and maintain interactions with physicians while using lovastatin OTC . The results showed that most study participants appropriately self-selected OTC statin therapy and managed their treatment . Use of OTC statins by consumers needing more intensive statin therapy or facing the risk of potential drug-drug interactions remains an area of concern but occurred infrequently in CUSTOM . These data are important for making an informed risk-benefit decision concerning OTC statin availability Background : Nearly perfect compliance seems to be indispensable to obtain the maximum benefit from highly active antiretroviral therapy ( HAART ) . Interventions to ensure a high level of adherence during a relatively long‐term period of therapy are necessary . Methods : This is a prospect i ve , r and omized , two‐arm controlled study including patients starting their first‐ or second‐line HAART who were r and omized to receive psychoeducative intervention to implement adherence ( experimental group [ EG ] ) or a usual medical follow‐up ( control group [ CG ] ) . We aim ed to study the efficacy of a psychoeducative intervention to ensure long‐term adherence to HAART , its relation with the virologic efficacy of treatment , and to determine the variables related to long‐term adherence . Visits were made at weeks 0 , 4 , 24 , and 48 for data collection . Self‐reported adherence was registered at each visit and its veracity was tested by r and omized blood analyses performed without previous warning to 40 % of patients . Appropriate adherence was defined as the consumption of ≥95 % of medication prescribed . Statistical analyses were performed both by the as treated ( AT ) and the intention to treat missing = failure ( ITT ) methods . Results : In all , 116 patients were included . At week 48 , 94 % of patients in the EG versus 69 % controls achieved adherence ≥95 % ( p = .008 ) ; 89 % of patients in the EG versus 66 % controls had HIV‐1 RNA levels < 400 copies/ml ( p = .026 ) . Overall , 85 % of patients with adherence ≥95 % but only 45 % of those with adherence < 95 % had viral load ( VL ) < 400 copies/ml ( p = .008 ) . In multivariate analysis , variables significantly related to adherence were having received a psychoeducative intervention  ( odds ratio [ OR ] , 6.58 ; p = .04 ) , poor effort to take medication ( OR , 5.38 ; p = .03 ) , and high self‐perceived capacity to follow the regimen ( OR , 13.76 ; p = .04 ) . Self‐reported adherence and drug plasma levels coincided in 93 % of cases . However , differences in adherence did not reach statistical significance in the ITT analysis although a clear tendency toward benefit was observed in EG . Conclusions : Specific and maintained psychoeducative interventions based on excellence on clinical practice are useful to keep high levels of adherence as well as high levels of viral suppression . There is a clear relation between high adherence levels and virologic success . Assessment of certain specific variables related to adherence may be helpful to monitor patient 's compliance in the clinical setting OBJECTIVES The authors determined patients ' report of prescription drug counseling activities after withdrawal of the pilot program to require patient package inserts in 1980 and implementation of Omnibus Budget Reconciliation Act of 1990 counseling requirements in 1993 . METHODS Four cross-sectional national telephone surveys were conducted in the fall of 1982 , 1984 , 1992 , and 1994 . Telephone households were chosen by r and om-digit dialing . Subjects had obtained a new prescription for themselves or for a family member at a retail pharmacy during the previous 4 weeks .  Verbal counseling rates at physician offices and pharmacies for five information categories and the distribution of written information at those locations were determined . RESULTS Spontaneous  verbal counseling  at the physician 's office has increased slightly , with the largest increases focused on the delivery of side effect and pre caution ary information . Slightly larger increases in pharmacy-delivered information regarding directions for use and pre caution s have occurred . Patient question ing has remained at single digit levels at both sites . The percentage of patients receiving any written information has increased from 5 % to 15 % at the physician 's office and from 16 % to 59 % at the pharmacy . CONCLUSIONS The data indicate small increases in  verbal counseling  but larger increases in the delivery of written information provided at the pharmacy . In light of Healthy People : 2000 goals for patient counseling and legislation encouraging private-sector initiatives , these data should help to refocus attention on the continuing need for effective patient education interventions Direct-to-consumer ( DTC ) pharmaceutical ads typically describe drug benefits in qualitative terms ; they rarely provide data on how well the drug works . We describe an evaluation of a " prescription drug benefit box"- data from the main r and omized trials on the chances of various outcomes with and without the drug . Most participants rated the information as " very important " or " important " ; almost all found the data easy to underst and . Perceptions of drug effectiveness were much lower for ads that incorporated the benefit box than for ads that did not . Most people we interviewed want benefit data in drug ads , can underst and these data , and are influenced by them Objective To determine how well patients could correctly recognize and comprehend the various information items on patient information leaflets , and to explore the reasons underlying poor comprehensibility . Methods  Leaflets from 30 r and omly selected , commonly prescribed medicines were examined by experts using protocol s to evaluate leaflet layout , language and content . The same leaflets were also evaluated by patients who had their medicines dispensed at 24 r and omly selected Swedish pharmacies . A question naire was used for the patients ’ examination . Results The results showed that most information on the leaflets is sound and is well comprehended by the patients . For two information items regarding ’ risks of interactions ’ and ’ contraindications ’ the patient scores were low , indicating poor comprehensibility . Conclusion Leaflets with low scores on warnings of interactions and contraindications were found to deliver more complex messages to older patients as compared to leaflets with high scores for these items The objective was to determine the influence of medicine labels incorporating pictograms on the underst and ing of instructions and on adherence .  Eighty-seven Xhosa participants attending an outpatient clinic who had been prescribed a short course of antibiotics were r and omly allocated to either a control group ( 41 participants given text-only labels ) , or an experimental group ( 46 participants given text + pictogram labels ) . All participants had a maximum of 10 years of formal schooling . Follow-up home visits were conducted after 3 - 5 days to assess underst and ing of instructions and to evaluate adherence . A high adherence of greater than 90 % was found for 54 % of the experimental group , compared with only 2 % of the control group . Average percentages for underst and ing in the control and experimental groups were 70 and 95 % , respectively , and average adherence was 72 and 90 % , respectively . The presence of pictograms was found to contribute positively to both underst and ing of instructions and adherence OBJECTIVE : To design , develop , and evaluate a simple , underst and able medicine label and patient information leaflet ( PIL ) for nystatin suspension , and to assess the effect of incorporating pictograms on underst and ing in low-literate participants . METHODS : Patient information material s were design ed and pretested in a pilot study ( n = 20 ) , and were subjected to the Fry 's readability test . The final evaluation was conducted with 60 low-literate participants who had a maximum of 7 years of formal schooling and for whom English was their second language . Demographic data were collected . Participants were r and omly allocated to a control ( text-only information ) or experimental ( text + pictogram information ) group , shown the medicine label and PIL , and asked to read them . A series of questions was asked about the instructions and an underst and ing level was calculated in each case . A second series of questions assessed patient acceptability of the material s. Differences in underst and ing were determined by χ2 tests . RESULTS : Both sets of these simple written material s were generally well understood . However , the presence of pictograms was shown to improve the comprehension of more complex information , result ing in significantly more participants in the experimental group obtaining a score for underst and ing > 80 % for both the medicine label and PIL . A clear preference for the material s incorporating pictograms was expressed . CONCLUSIONS : The presence of pictograms had a positive effect in the acquisition and comprehension of drug information BACKGROUND Patients ' ability to underst and information about medication is crucial for safety and effectiveness . Rates of illiteracy worldwide indicate that written information alone can not meet many patients ' needs . Medication pictograms are an alternative , but may be culturally sensitive . Previous testing has used large pictograms , which are impractical for conventional drug information formats . OBJECTIVE To compare 2 sets of pictograms for instructions or warnings ( from the US and South Africa ) for underst and ability by adults in the UK and examine the effects of pictogram size and repeat presentation on underst and ability among older adults . METHODS In the first part of the study , 160 adults ( aged 17–83 y ) review ed and interpreted 10 pictograms .  In the second , 67 older adults ( aged 65–96 y ) were r and omly assigned to review 10 small or large pictograms . After giving their interpretation , they were informed of the correct meaning . One week later , they were shown the same pictograms and gave their interpretation . RESULTS The pictograms for the 10 different instructions and warnings showed great variation in interpretation rates ( 7.5–90 % ) , with few significant differences between the US and South African versions . Only 3 were understood by ≥85 % of the population . Pictograms performed significantly better if they were larger and at the second presentation . CONCLUSIONS Pictograms have the potential to help patients underst and information on drug therapy . This study shows that some existing pictograms are not easily interpreted and that testing is needed before their implementation . A reduction in their size to allow incorporation into conventional written formats may cause additional problems for patients Three thous and four hundred and ten patients recruited at 254 pharmacies took part in a national postal survey of the effect of prescription information leaflets .  The patients had been prescribed penicillins , non-steroidal anti-inflammatory drugs ( NSAIDs ) or β-adrenoceptor antagonists .  The 1809 patients who received leaflets knew more about their medicines , especially the side effects and were significantly more satisfied than the 1601 patients who were not given additional written information . The leaflets were found to be effective when issued in the north , in the south and in small , medium and large towns . Patients of both sexes , all age groups and social classes were found to benefit from the leaflets and almost everyone ( 97 % ) thought they were a good idea . These results confirm and extend our previous findings and add further support for the routine use of information leaflets with prescribed medicines One hundred and ninety-six patients over the age of 65 years suffering from joint pain were r and omised to receive one of three patient information leaflets describing a hypothetical pain medication , a st and ard textual patient information leaflet ( PIL ) given out by a pharmaceutical chain , and two alternate-forms depicting information with icons and graphs . The results showed that patients r and omised to the traditional PIL were less likely to consider taking the hypothetical medication OBJECTIVES To characterize the degree of disparity between physicians ' perceptions of older patients ' medication regimen and patients ' perceptions of their regimen . DESIGN Prospect i ve observational . Physicians and patients were blinded at index visit ; after , trained medical students made home visits , collecting information about medications that was compared with physician question naires . SETTING Community family medicine residency program . PARTICIPANTS Patients age 65 and older presenting for routine visit , taking at least four prescription medications , and seen by index physician three or more times in 
    Output:
    
Findings showed that patients request information about a drug 's indication , expected benefits , duration of therapy , and a thorough list of potential adverse effects .
The evidence about label format supports the use of larger fonts , lists , headers , and white space , using simple language and logical organization to improve readability and comprehension .
Evidence was not sufficient to support the use of pictographic icons .
Little evidence linked label design or content to measurable health outcomes , adherence , or safety .
Conclusions : Evidence suggests that specific content and format of prescription drug labels facilitate communication with and comprehension by patients .