Effect of a Japanese drug alert pictogram on medication-taking/driving behavior

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Abstract
Objective: This study aimed to determine the usefulness and effects of a pictogram for alerting patients about drugs that affect driving in order to prevent traffic injury and maintain good adherence. Method: The participants comprised 600 men and 600 women aged 20–79 (49.58 ± 16.21) years, registered with an Internet research company. All were licensed to drive a car and were taking prescribed medication. The outcome measures were: 1) awareness of existing pictogram, 2) perceived driving risk after viewing the pictogram, 3) usefulness of the pictogram, and 4) medication-taking and driving behavior after viewing the pictogram. Results: Few respondents (5.4%) were aware of the Japanese pictogram issued by the Council for Appropriate Drug Use. Participants evaluated their driving risk as moderate-to-high (3.51 ± 0.69) after viewing the pictogram, and risk perception was higher among respondents in their 50 s and 60 s than among those in their 20 s. Across all respondents, the pictogram was rated as follows (on a 5-point Likert scale): effective for warning, 3.79 ± 0.90; informative, 3.75 ± 0.84; understandable meaning (comprehensibility), 3.90 ± 0.96; simplicity, 3.71 ± 0.95; and eye-catching, 3.60 ± 0.98. We defined the following as positive behavior: taking medication according to the instructions of a medical professional (good compliance), stopping driving, and consulting medical professionals. The positive behavior rate was 63.2%. Being shown the pictogram might lead to more positive medication-taking and driving behavior among respondents who are female and have lower driving frequency, higher levels of risk perception, and higher evaluation of the pictogram compared to their counterparts. Conclusion: A pictogram is a potentially useful and effective tool for communicating risk and supporting decision-making by supplying drivers with tailored information. However, we assume that some people who drive frequently must drive for work, go to the hospital, etc. It is essential, in these cases, for medical professionals to be more deeply involved with the patients and to maintain lines of communication by listening to patients’ descriptions of their everyday life. By adding these pictograms to the labeling of potentially driver-impairing medications (such as by putting them on the outer packaging, package inserts, and inner medicine containers), it is expected that they can better inform users regarding safe behavior and promote medication adherence.

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