Major health disparities in chronic disease control and outcomes exist among Latinos, the fastest growing segment of the U.S. population. If these disparities continue, demographic trends will magnify their adverse health, societal, and economic impact. Chronic disease control often requires successful management of multiple prescription medications, yet many patients struggle to understand medication information, which contributes to poor adherence and outcomes. The situation is particularly challenging for Latino patients, the majority of whom have low health literacy and/or limited English proficiency. Medication instructions that incorporate illustrations and plain language have been proven to enhance medication management, particularly among patients with low health literacy. However, few tools have been developed to generate such instructions in a way that could be delivered to Latino and other underserved populations. PictureRx is an innovative, effective, affordable, evidence-based technology which enables patients, their caregivers, or health professionals to rapidly develop illustrated medication instructions. The PictureRx platform, which is available in English via the internet, is well-suited for adaptation to serve the needs of the Latino community, where it may enhance medication management and reduce health disparities.
The Specific Aims of this proposal are to: 1) Adapt PictureRx into a Spanish-language, culturally appropriate educational intervention for improving medication management and outcomes among Latinos, and 2) Conduct a small randomized controlled trial to evaluate the effect of the Spanish-language PictureRx, compared to traditional prescription instructions, on Latinos'knowledge of their medication regimens. The project team consists of experienced software engineers and academic physicians with expertise in business development and clinical research among underserved populations.
For Aim 1, we will conduct focus groups and interviews with Latino patients, their caregivers, and health care professionals, as well as leading national experts who have agreed to serve as key informants. We will use this information in an iterative fashion to adapt PictureRx for the Latino community.
For Aim 2, we will enroll 200 patients in a randomized study at the Cayce Clinic, a safety net clinic which primarily serves Latino patients. Patients in the intervention group will receive PictureRx illustrated schedules of their daily medication regimen, while those in the control group will receive usual care. The study will evaluate the effect of PictureRx on Latino patients'understanding of their medication regimen (primary outcome), as well as their self-reported adherence (secondary outcome). Through a process of development and evaluation which engages the Latino community, our goal is to complete a culturally-appropriate and effective adaptation of PictureRx for Latinos. This will set the stage for subsequent efforts to disseminate PictureRx as an appropriate technology to reduce health disparities.
The Institute of Medicine and this SBIR announcement have called for innovative approaches to reduce health disparities. The need for such interventions may be greatest among Latinos, who represent the fastest growing segment of the U.S. population. PictureRx is an innovative, effective, affordable, and evidence-based technology that produces illustrated medication instructions to improve medication management. This proposal seeks to develop a culturally-appropriate adaptation of PictureRx for the Latino community that may serve as an effective technology to reduce Latino health disparities
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| Mohan, Arun V; Riley, M Brian; Boyington, Dane R et al. (2013) Illustrated medication instructions as a strategy to improve medication management among Latinos: a qualitative analysis. J Health Psychol 18:187-97 |
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