Courageous leadership is needed to solve the problem. Putting the patient at the center and figuring out what is best for the patient should be the unifying theme. The problems of drug labeling and patient understanding need to be the priority—not just putting these problems on a list, but devoting money and time to solving them.

Funding is needed to collect evidence on what needs to be done. Wood showed us a system for standardizing drug labels—the universal medication schedule, or UMS. That was courageous leadership. Many at this conference said it would be good to obtain evidence about this approach. Obtaining evidence requires funding, but we need to be careful to identify what evidence we need.

Do we really need evidence of improved adherence to move forward with a standardized drug label? That is hard to get. On the other hand, we are good at measuring comprehension. It is logical that if one cannot comprehend the instructions on a drug label, one is most likely not to adhere to those instructions. Therefore, a good first step is evidence of improved comprehension, which we hope will then lead to improved adherence.

Someone spoke today about the idea that clinical trials could use a standardized schedule for administration of medications. That is an exciting idea, and Goldhammer said it was something worth looking at. Another exciting idea is for the Department of Veterans Affairs to introduce a standardized label and look at the effects.

Several people raised the issue of the cost of introducing a standardized label. We are currently spending a great deal on treating adverse drug events (ADEs), and we are going to be spending more if we do not address the current problems. Treating ADEs costs a lot, perhaps more than trying to fix the problem of drug labeling.

Many today said that drug labeling is only one issue in the complexity surrounding patient understanding and use of medications. That is true. Certainly counseling, better written information, and effective translations are also important. But change must start somewhere. The drug label is the primary source patients turn to for instructions on how to take their medications, so start with that. Improve the drug label.

Stopping once the drug label is changed is not an option. What is done with the drug label can be used to address such issues as translation into other languages. Physician and pharmacist counseling are also important components. But with a standardized label, a standard way of taking medication, patient counseling may benefit.

It is time to do a better job for our patients.



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