Background
My project
is design to assist the population of the visually impaired to take medications
safely. About 285 million people are
visually impaired worldwide, and although this a significantly small amount
compared to our population of almost 7 billion, they have to change their
lifestyles financially, medically, and emotionally. There are about 10 million
blind and visually impaired people in the United States. Of these numbers, 1.3 million Americans are
legally blind, and more than one half (6.5 million) are 65 years of age or
older. Once they reach 75 years old, the
prevalence of blindness and vision impairment increase rapidly. Currently, people who are 80 years and older
make up 8% of the population and account for 69% of the blindness.The leading cause of vision impairment and blindness in the United States is age-related eye diseases such as cataracts, glaucoma, age-related macular degeneration, and diabetic retinopathy. For black Americans, cataract and open-angle glaucoma account for more than 60% of blindness, while macular degeneration account for 54% of all blindness for white Americans. Cataract is responsible for approximately 50% of low vision cases found in white, black, and Hispanic patients. In 2007, the impact of vision loss on the American economy was estimated to be $51.4 billion annually. The number of persons who will be blind is projected to increase by 70% by the year 2020. Most elderly people with visually impaired are not aware of services that can help them cope with vision loss or techniques and devices that can help their daily activity living easier. Almost 80% of visually impaired people are required to take some sort of medication, and often cannot see the instruction labels on their medications. The lack of available education for the visually impaired and jobs leaves many financially unstable or poor. Emotionally, becoming blind is a very traumatic experience because, soon enough, a person’s lifestyle is based on whether or not he or she can see.
Introduction
For my
project, I focused on the issue of safe medication use for the visually
impaired. Why? Because taking medications are a daily part of a visually
impaired person’s life, and it is important that medications are taken safely
and correctly to prevent the visually impaired person to take the wrong
medication or the incorrect dose of medications. Some visually impaired people
may take more than one medication and the task of trying to memorize how to
take several medications could be a challenge and impossible to do so without
any aids. In addition, the inability to
read medication labels, instruction sheets, and medication inserts containing
medication information put them at a high risk of taking incorrect medication
in the wrong amount at the wrong time, and jeopardize their health at
risk. Some may take expired medications
for not being able to check the expiration date of medications. If errors are made by the pharmacy, they
can’t tell the differences at all.
Overall, there are many issues associated with vision loss including
inability to read prescription labels, determine the size, shape, color, or
markings to distinguish medications from each other. A study by AFB indicated that 65% of people
surveyed expressed concern on the ability to properly identifying the correct
medication.
Current regulations and guidelines for consumer medication information (CMI) are from state boards of pharmacy, Food and Drug Administration (FDA), Medicare Prescription Drug, Improvement, and Modernization Act Provision, and the National Institute on Disability and Rehabilitation Research (NIDRR). All of these institutions do not spell out the required format of information on prescription labels for CMI. Therefore, a specific guideline is needed for pharmacists and pharmacies to make important medication available and accessible to patients with visually impaired. CMI requires that medication labels should contain the following information: (1) customer name; (2) medication name; (3) dosage instructions; (4) expiration date; (5) prescription number; (6) refill information; (7) pharmacy name and phone number; (8) prescribing doctor’s name and phone number; (9) warning information; and (10) reminding information for patients to check the drug information sheet for other important medication information. So far, several efforts have been made to help the visually impaired patients take their medications correctly. They include but are not limited to large-print prescription labels, enhanced magnification or magnifying glass, braille readers or raised labeling, assistive technology such as audible prescription label readers, recorders, or scanners, voice glucometer, Script Talk, and RFID Chip. Two of the most critical barriers to the use of assistive technology are the lack of awareness and cost of some assistive technologies. Several studies showed that the importance of label format-font-type, point size, letter compression, line spacing-on readability, comprehensibility, were useful to patients with visually impaired. A significant improvement was noted in comprehension and adherence among older adults if the prescription label was printed in 22 point Arial font which was almost 3 times the point size usually used on the prescription labels.
On the personal level, different types of services are available to help them take medications correctly. They are extended consultation service through caregivers to provide extended consultation to ensure that patients understand accurately while attempting to provide education, telephone service to access pharmacists 24/7 regarding any questions or concerns, home delivery to deliver the medications directly to patients at home, feel pills to allow patients to touch and feel the size and shape of the pills so that they can distinguish them or be able to tell them apart, using specific supplies to make sure that the size and shape of the pills don’t change over time due to different drug manufacturers.
Other than these assisting aids, guidelines have been developed for prescription labeling and consumer medication information for people with vision loss. The American Foundation for the Blind (AFB) through a collaborative project with the American Society of Consultant Pharmacists (ASCP) Foundation developed guidelines for pharmacists and pharmacies with specific recommendations for making important medication information accessible for patients with vision loss. These guidelines help make drug labels safer and contain useful information for pharmacists and pharmacies to follow. Through memoirs written by visually impaired people, I found that, most times, the visually impaired require assistance when taking their medications because they cannot see the instruction label. However, most times assistance is only available for those who can afford it and are not there 24/7. I targeted this issue and decided to create a medication label designed especially for the visually impaired that is practical, easy to make and use, and accessible to anyone at low cost.
Current regulations and guidelines for consumer medication information (CMI) are from state boards of pharmacy, Food and Drug Administration (FDA), Medicare Prescription Drug, Improvement, and Modernization Act Provision, and the National Institute on Disability and Rehabilitation Research (NIDRR). All of these institutions do not spell out the required format of information on prescription labels for CMI. Therefore, a specific guideline is needed for pharmacists and pharmacies to make important medication available and accessible to patients with visually impaired. CMI requires that medication labels should contain the following information: (1) customer name; (2) medication name; (3) dosage instructions; (4) expiration date; (5) prescription number; (6) refill information; (7) pharmacy name and phone number; (8) prescribing doctor’s name and phone number; (9) warning information; and (10) reminding information for patients to check the drug information sheet for other important medication information. So far, several efforts have been made to help the visually impaired patients take their medications correctly. They include but are not limited to large-print prescription labels, enhanced magnification or magnifying glass, braille readers or raised labeling, assistive technology such as audible prescription label readers, recorders, or scanners, voice glucometer, Script Talk, and RFID Chip. Two of the most critical barriers to the use of assistive technology are the lack of awareness and cost of some assistive technologies. Several studies showed that the importance of label format-font-type, point size, letter compression, line spacing-on readability, comprehensibility, were useful to patients with visually impaired. A significant improvement was noted in comprehension and adherence among older adults if the prescription label was printed in 22 point Arial font which was almost 3 times the point size usually used on the prescription labels.
On the personal level, different types of services are available to help them take medications correctly. They are extended consultation service through caregivers to provide extended consultation to ensure that patients understand accurately while attempting to provide education, telephone service to access pharmacists 24/7 regarding any questions or concerns, home delivery to deliver the medications directly to patients at home, feel pills to allow patients to touch and feel the size and shape of the pills so that they can distinguish them or be able to tell them apart, using specific supplies to make sure that the size and shape of the pills don’t change over time due to different drug manufacturers.
Other than these assisting aids, guidelines have been developed for prescription labeling and consumer medication information for people with vision loss. The American Foundation for the Blind (AFB) through a collaborative project with the American Society of Consultant Pharmacists (ASCP) Foundation developed guidelines for pharmacists and pharmacies with specific recommendations for making important medication information accessible for patients with vision loss. These guidelines help make drug labels safer and contain useful information for pharmacists and pharmacies to follow. Through memoirs written by visually impaired people, I found that, most times, the visually impaired require assistance when taking their medications because they cannot see the instruction label. However, most times assistance is only available for those who can afford it and are not there 24/7. I targeted this issue and decided to create a medication label designed especially for the visually impaired that is practical, easy to make and use, and accessible to anyone at low cost.
Thesis
The visually impaired, making up about 285 million people world wide, lacks knowledge and tools to learn about the necessary skills needed to take medication safely.