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Health care providers, particularly English-speaking professionals participating in the
delivery of short-term medical care in developing countries, face the challenge of
delivering crucial information in a culturally competent way to people who may rarely or
never have encountered the complex and important details of written medication
instructions. Taking into account language, education, and literacy barriers, this study
tested the effectiveness of a picture-based medication instruction sheet with bilingual
labels during the operation of a temporary clinic in rural western Kenya. The goal was
that medical treatment would be more effective and dangerous errors avoided if the
patients could demonstrate effective patient recall of medication instructions immediately
after they were given.
In the sample of 248 patients, the pictograph was able to decrease the proportion of
patients with multiple errors (p = 0.019). However, 35.8% of the sample still had one or
more error. There was an unexpected lack of overlap in this sample among literacy, level
of education, and ability to speak English. The pictograph was most successful in
decreasing errors among uneducated patients (p=0.026), and the intervention had more of
an impact among females (p=0.002) than among males. Future research will build on
these findings to develop other interventions that can address these potentially lifethreatening
mistakes that occur even among educated, literate, and English-speaking
patients. Future work will also further explore the social context that would cause males
to do worse than females. |
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