Beyond words: Enhancing medication understanding with pictograph-integrated pharmacist counseling in linguistically diverse patients
Abstract
Background: Patients frequently struggle with medication adherence because of issues such as poor recall, forgetfulness, or a misunderstanding of medical instructions. This can lead to improper medication use, uncontrolled health conditions, and increased hospitalizations. Research indicates that pictographs can improve patient understanding and retention of medication information, suggesting their potential value in pharmacy consultations. Objectives: This study aimed to evaluate the impact of pharmacist-led counseling with pictographs on patients’ comprehension of medication usage and side effects. We hypothesized that integrating pictographs into verbal counseling would enhance understanding, especially among linguistically diverse populations. Methods: Conducted from April to June 2020 in 2 community pharmacies serving English- and Spanish-speaking patients in Austin, Texas, the study involved a prospective longitudinal cohort design. Participants were assigned to 1 of 4 cohorts based on their medication type—English- and Spanish-speaking patients receiving new acute medications lasting 90 days or less, and those with new or refilled chronic medications lasting longer than 90 days. All groups received pictograph-assisted counseling using the Three Prime Questions framework, which included a teach-back assessment and a post-counseling questionnaire. Results: A total of 27 participants were enrolled, with 21 in the acute cohort and 6 in the chronic cohort. Most participants (70.4%) preferred Spanish as their communication language. Notably, 85.7% of participants reported that the pictographs enhanced their understanding of their medications, with 93.8% of Spanish speakers expressing this sentiment. All participants indicated that they would be willing to use the pictographs again in future counseling sessions. Conclusion: Despite challenges from the COVID-19 pandemic, the results indicate that pictographs significantly improve medication comprehension among diverse linguistic groups. These findings provide a promising foundation for future research into the role of pictographs in enhancing patient understanding and adherence in various pharmacy settings.
Related
- A Structured, Auditable Taxonomy for Pharmacist-Identifiable Medication-Related Risk Signals in Routine Admission Data: A Retrospective Medication Safety Audit in a High-Risk Inpatient Cohort
- Adherence of HIV/AIDS patients following Medication Therapy Management and Pharmacist Counselling at a Public Hospital in Yogyakarta, Indonesia
- Pharmacist-Led Comprehensive Medication Management and Patient Outcomes in Pediatric Intensive Care Unit Patients: A Multicenter Cohort Study
- Impact of clinical pharmacist interventions in psychiatric hospitals on clinical and medication-related outcomes: a systematic review and meta-analysis
- Implementation of medication alert systems and pharmacist satisfaction: a questionnaire-based study
BibTeX
@article{garling2026beyond,
title = {{Beyond words: Enhancing medication understanding with pictograph-integrated pharmacist counseling in linguistically diverse patients}},
author = {K. Ashley Garling and Maeleigh Tidd},
journal = {JAPhA Practice Innovations},
year = {2026},
month = oct,
doi = {10.1016/j.japhpi.2026.100133},
url = {https://doi.org/10.1016/j.japhpi.2026.100133},
note = {CC BY},
}
RIS
TY - JOUR
TI - Beyond words: Enhancing medication understanding with pictograph-integrated pharmacist counseling in linguistically diverse patients
AU - K. Ashley Garling
AU - Maeleigh Tidd
PY - 2026
DA - 2026/10/30
JO - JAPhA Practice Innovations
DO - 10.1016/j.japhpi.2026.100133
UR - https://doi.org/10.1016/j.japhpi.2026.100133
AB - Background: Patients frequently struggle with medication adherence because of issues such as poor recall, forgetfulness, or a misunderstanding of medical instructions. This can lead to improper medication use, uncontrolled health conditions, and increased hospitalizations. Research indicates that pictographs can improve patient understanding and retention of medication information, suggesting their potential value in pharmacy consultations. Objectives: This study aimed to evaluate the impact of pharmacist-led counseling with pictographs on patients’ comprehension of medication usage and side effects. We hypothesized that integrating pictographs into verbal counseling would enhance understanding, especially among linguistically diverse populations. Methods: Conducted from April to June 2020 in 2 community pharmacies serving English- and Spanish-speaking patients in Austin, Texas, the study involved a prospective longitudinal cohort design. Participants were assigned to 1 of 4 cohorts based on their medication type—English- and Spanish-speaking patients receiving new acute medications lasting 90 days or less, and those with new or refilled chronic medications lasting longer than 90 days. All groups received pictograph-assisted counseling using the Three Prime Questions framework, which included a teach-back assessment and a post-counseling questionnaire. Results: A total of 27 participants were enrolled, with 21 in the acute cohort and 6 in the chronic cohort. Most participants (70.4%) preferred Spanish as their communication language. Notably, 85.7% of participants reported that the pictographs enhanced their understanding of their medications, with 93.8% of Spanish speakers expressing this sentiment. All participants indicated that they would be willing to use the pictographs again in future counseling sessions. Conclusion: Despite challenges from the COVID-19 pandemic, the results indicate that pictographs significantly improve medication comprehension among diverse linguistic groups. These findings provide a promising foundation for future research into the role of pictographs in enhancing patient understanding and adherence in various pharmacy settings.
SN - 2949-9690
ER -