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ACTA Pharmaceutica Sciencia
2026 , Vol 64 , Num 3
Comprehensibility of pharmaceutical pictograms in patient information leaflets: A cross-sectional study in Ankara, Türkiye
1 Başkent University, Faculty of Health Science, Department of Healthcare Management, Ankara, TürkiyeDOI : 10.23893/1307-2080.APS64021 Viewed : 380 - Downloaded : 269 This study aimed to assess the comprehensibility of commonly used pharmaceutical pictograms in Türkiye and examine how socio-demographic characteristics, health literacy, and medication-related behaviors influence pictogram interpretation. This cross-sectional descriptive study was conducted among 626 adults residing in Ankara, Türkiye, using an online survey. The survey included socio- demographic questions, a Single-Item Health Literacy Screening (SILS), a Medication Adherence Scale (MMAS-4), and a Pictogram Comprehension Test covering 12 pharmaceutical pictograms. Guessability scores and guessability performance were calculated to measure pictogram comprehensibility. The average guessability performance score was 19.48 ± 14.83, indicating a low overall comprehension level. Among the 12 pictograms, only one (P5, 76.3%) met the ISO 9186-1 comprehension criterion of 67%, while P7 had the highest incorrect response rate (94.9%). Age, gender, occupation, income, chronic illness status, health literacy, awareness of medication side effects, and medication instruction reading habits were found to significantly influence pictogram comprehension (p<0.05). The findings suggest that pharmaceutical pictograms in Türkiye may not be sufficiently effective as standalone communication tools, as their comprehensibility is influenced by multiple socio-demographic and behavioral factors. To improve their effectiveness, pictograms should be redesigned based on user feedback, standardized in accordance with ISO guidelines, and supplemented with educational interventions. Keywords : pharmaceutical pictograms, health literacy, medication adherence, patient information leaflets, Türkiye