Implementation of pharmaceutical pictograms in pharmacy practice: A systematic review

Incorporating pharmaceutical pictograms into patient education and counseling within pharmacy practice may enhance understanding and promote safer medication use, especially among populations with limited health literacy.

To review empirical evidence on the use and evaluation of pharmaceutical pictograms in medication-use contexts relevant to pharmacy practice.

A systematic review was conducted in accordance with PRISMA guidelines. Web of Science, Scopus, and MEDLINE were searched for original empirical studies published between January 2010 and October 2025. Following duplicate removal, 1,449 titles and abstracts were screened, and 107 full-text articles were assessed for eligibility. Original empirical studies evaluating pharmaceutical pictograms in real-world or simulated medication-use contexts were eligible for inclusion. Given the substantial methodological and clinical heterogeneity across studies, a narrative synthesis was undertaken, and methodological quality was assessed using the Mixed Methods Appraisal Tool.

The inclusion criteria were met by 19 studies. Interventions included pictogram-enhanced medication labels, patient information leaflets, warning symbols, and educational materials applied across community pharmacy, hospital, primary care, and outpatient settings. Most studies reported improvements in medication comprehension, dosing accuracy, technical skills, and error reduction, particularly among populations with limited health literacy, older adults, and caregivers. Effects on medication adherence were more variable and context-dependent.

Pharmaceutical pictograms appear to be well-accepted tools for supporting medication-related communication, particularly when integrated into broader educational or counseling interventions. Evidence from the included studies suggests generally beneficial effects on medication comprehension and potential reductions in medication-related errors, whereas effects on adherence vary according to context. Pictograms may therefore be used as complementary tools alongside verbal counseling and simplified written information in routine pharmacy practice.