Background: The purpose of this pilot study was to evaluate and refine an adjuvant system of colour-specific symbols (the Tachygraphic Color Organized Medication System (TCOM)) that are added to medication bottles and to assess whether this system would increase the ability of patients 65 years of age or older in matching their medication to the indication for which it was prescribed.  The labels consist of a series of repeated coloured images on a 0.75 inch adhesive strip that can be attached below a standard medication bottle label.  Each coloured medication symbol strip represents one of 19 common medication indications.

Methods: This study was conducted in two phases, consisting of three focus groups of patients from a family medicine clinic in North Texas, USA, (n = 25) and a pre-post medication identification test in a second group of patient participants (n = 100).  Results of focus group discussions were used to refine the medication label symbols according to themes and messages identified through qualitative triangulation mechanisms and data analysis techniques.  A pre-post medication identification test was conducted in the second phase of the study to assess differences between standard labelling alone and the addition of the refined colour-specific symbols.  The pre-post test examined the impact of the added labels on participants' ability to match their medication accurately to the indication for which it was prescribed when placed in front of participants and then at a distance of 2 feet (0.6m).

Results: Participants appreciated the addition of a visual aid on existing medication labels because it would not be necessary to learn a completely new system of labelling, and generally found the colours and symbols used in the proposed labelling system easy to understand and relevant.  Concerns were raised about space constraints on medication bottles, having too much information on the bottle, and having to remember what the colours meant.  Symbols and colours were modified if they were found unclear or inappropriate by focus group participants.  Pre-post medication identification test results in a second set of participants demonstrated that the addition of the symbol label significantly improved the ability of participants to match their medication to the appropriate medical indication at a distance of 2 feet (p less than 0.001) and approached significant improvement when placed directly in front of participants (p = 0.07).

Conclusions: The proposed medication symbol label system provides a promising adjunct to national efforts in addressing the issue of medication misuse in the home through the improvement of medication labelling.  Further research is necessary to determine the effectiveness of the labelling system in real-world settings.