Comprehensibility of pharmaceutical pictograms: Effect of prospective-user factors and cognitive sign design features

Background: The people's comprehensibility regarding the meaning of internationally recommended pictograms is an important factor in the correct usage of medications. Objective: To investigate the relationship between the guessability of the pharmaceutical pictograms, the cognitive sign features, and prospective-user factors. Methods: A total of 351 Iranian people participated in this study. Two questionnaires were used to measure guessability and cognitive design features regarding the pharmaceutical pictograms. A single-sheet questionnaire was also developed to collect demographic data. Results: According to the 67% correctness criterion suggested by ISO 3864:P3, 18 pictograms were understandable by the participants. Moreover, of the five cognitive features, "semantic closeness" and "meaningfulness" had the most correlation with the guessability score. In terms of personal factors, understanding of the pictograms' meaning was negatively correlated with age, while it had no association with the occupation. Conclusions: Some pharmaceutical pictograms developed by reliable international organizations can be used in a community only after redesigning and testing among the prospective users. The findings indicated that some pharmaceutical pictograms were not comprehensible for most participants. It is therefore expected that using a combination of pictograms with written messages and training could help in conveying the messages by pharmaceutical pictograms.