Design And Evaluation of Pictograms for Communicating Information about Adverse Drug reactions to Antiretroviral Therapy in Indian human Immunodeficiency Virus positive patients

Rajesh, Radhakrishnan and Vidyasagar, Sudha and Varma, Muralidhar and Sharma, Shreekant (2012) Design And Evaluation of Pictograms for Communicating Information about Adverse Drug reactions to Antiretroviral Therapy in Indian human Immunodeficiency Virus positive patients. Journal of Pharmaceutical and Biomedical Sciences, 16 (10). pp. 1-11.

[img] PDF - Published Version
Restricted to Registered users only

Download (910kB) | Request a copy


Background: The adverse drug reactions (ADRs) to highly active antiretroviral therapy (HAART) are linked to poor medication adherence and altered quality of life in HIV Positive patient’s particularly in countries with a high illiteracy rate such as India. In India inability to read and understand written medication instructions is a major contributory factor for poor adherence. Patients’ ability to understand adverse effects of antiretroviral (ARV) therapy is crucial for safety and efficacy of the HIV treatment. Pictograms is an alternative but culturally sensitive to improve patient’s knowledge, particularly in illiterate and low-literate groups. Objective: The aim of this study was to design simple and culturally sensitive pictograms for adverse drug reactions to antiretroviral therapy and to assess its understandability in Indian HIV positive patients. Methods: A total of simple 20 pictograms was designed for adverse drug reactions to antiretroviral regimen either from photos or images from textbooks in accordance with the local culture (local pictograms). Testing for understanding of these 20 pictograms was conducted in 50 hospitalized HIV positive Indian patients who were on antiretroviral (ARV) therapy and ranged from having no education to college level education, were interviewed. Demographic data were collected, and participants were tested for their interpretation of all 20 pictograms using International Standard Organization (ISO) criteria for acceptance greater than 67% in phase I and in phase II after 3 weeks of follow-up. Participants were interviewed in medical wards at Kasturba Hospital, Manipal, India. Results: Of the 20 designed pictograms, only 9 of the 20 pictograms and 17 of the 20 pictograms met the International Standard Organization (ISO) >67% for correct criterion in phase I and phase II respectively. Standard of higher education level had a significant influence on the interpretation of pictograms compared to low literate. The illiterate patients showed a least understanding of pictograms. Significant differences in correct interpretation of pictograms were found between pictograms of polyurea and constipation (P<0.05). No significant differences in correct interpretation were observed between gender and treatment naïve or treatment experienced HIV patients. Conclusion: Pictograms about ARV medication adverse effects were designed for viewers with illiteracy and low-literacy skills, userfocused, employing a consultative, iterative process. The increase in use of newer ARV in India increases the risk for ADRs and poor adherence to ARV therapy. It is therefore recommended that HIV clinicians must use pictograms as a counseling aid in combination with text or verbal information when educating HIV patients about adverse effects of ARV therapy.

Item Type: Article
Uncontrolled Keywords: Pictograms, HIV, AIDS, Adverse drug reactions, Antiretroviral therapy, Highly active. India.
Subjects: Medicine > KMC Manipal > Medicine
Pharmacy > MCOPS Manipal > Pharmacy Practice
Depositing User: KMC Manipal
Date Deposited: 18 Apr 2012 04:20
Last Modified: 22 Oct 2013 06:15

Actions (login required)

View Item View Item