Using an Automatic Tool to Identify Potential Readability Issues in a Large Sample of Medicinal Package Inserts

Automatic Quantification of Abbreviations in Medicine Package Leaflets and Their Comprehension Assessment

Medication errors occur as a consequence of misunderstandings with abbreviations and symbols (A&S). According to pharmaceutical regulations, A&S should be avoided in medicine package leaflets (PLs). Using a sample of 531 Portuguese PLs, this study aims at: quantifying A&S in PLs, comparing how A&S were distributed, identifying non-recommended units of measure, checking whether the full meaning of abbreviations was presented, and determining educated peoples' interpretation of A&S. A computational tool was used to identify A&S. Participants' comprehension was evaluated with a questionnaire. Overall, 828 different A&S were identified. PLs of prescribing medicines contained a significantly higher proportion of A&S than PLs of over-the-counter medicines (chi-square = 13.4; p = 0.004). A&S with their meaning not fully described and units of measure with a non-recommended format were identified. Only 9.9% of the questionnaire answers were correct. Portuguese PLs may need to be revised. The software used is appropriate to checking A&S in PLs.