The use of pictograms in the health care: A literature review

Background: The ability of patients to understand pharmacotherapy information is critical to the successful use of medications. One of the risk factors that may predispose the patient to non-adherence is the low retention of verbal information. Thereby, one way to facilitate the understanding of patients regarding prescribed pharmacotherapy is to incorporate pictograms to transmit information in a clear, expeditious, and simple manner. Objective: To evaluate literature on the use of pictograms for health professionals and assess their impact on helping patients increase the understanding of and compliance with medical instructions. Methods: Searches were conducted from February to March 2012. We searched articles in databases, using the keywords: "pictograms," "health," "health care professionals," "medication" and " pictorial representation." After this step, we performed a manual sorting, evaluating titles and abstracts. The articles were carefully examined according to the following variables: (1) geographic location and setting of the studies; (2) study design; (3) number of pictograms used; (4) education; (5) sample size; (6) age of participants; (7) function of pictograms; (8) limitations described in the literature evaluated. Results: The research identified 136 published studies. After the exclusion process, 24 studies met inclusion criteria and from those, 50% were conducted in Africa, and 51.4% were considered effective. In the evaluation of the function of the pictograms, to verify their utility, 23 studies used to educate patients on the use of medications. The translation and cultural adaptation of pictograms was performed in five studies, and one study considered this process as validation. Conclusion: In this review, the literature contained only a few studies employing pictograms by health professionals, and most of these were meant for the use of medications. Moreover, the specific results reinforce the need for more studies in this area to provide a more complete approach about pictograms in the heath care. (C) 2014 Elsevier Inc. All rights reserved.