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Approximately 4.5 million outpatient visits each year are related to adverse drug events, and recent estimates place the cost to the US health care system at more than $8 billion annually. While the underlying factors leading to medication errors vary, patient misunderstanding of how to take their prescriptions is likely to be a major cause.

Recognizing the risk to patient safety, the Institute of Medicine (IOM) called for the creation of a Universal Medication Schedule (UMS) to better describe how to take daily-use, pill-form medications. For example, the UMS modified “take one tablet twice daily” to “take one pill in the morning and one pill at bedtime.” Figure 1 shows the UMS framework, including dosing periods and simplified instructions.

With support from CHCF, a team of researchers sought to expand the UMS framework to non-pill-form medications, short-term, as needed, and tapered- or escalating-dose medications — all of which are often difficult for patients to self-administer. Assisted by health literacy and drug labeling experts, and in cooperation with patients, the team created a set of prescription instructions aimed at supporting patients’ understanding and use of these types of drugs.

This article, published in BMJ Open, debuts the improved instructions, and documents best practices related to the presentation of numbers, phrasing of timing and duration of use, need for external aids, and counseling.