@article{11879, keywords = {acetaminophen, medication errors, vision, visual acuity}, author = {Rebecca J. Mullen and Laura M. Curtis and Rachel O'Conor and Marina Serper and Danielle McCarthy and Stacy C. Bailey and Ruth M. Parker and Michael S. Wolf}, title = {Visual acuity, literacy, and unintentional misuse of nonprescription medications.}, abstract = {

PURPOSE: Results of a study of associations between visual acuity and the risk of misuse of nonprescription acetaminophen products in a sample of community-dwelling adults are reported.

METHODS: In a study involving English-speaking adults at 4 primary care clinics, the potential for misuse of nonprescription acetaminophen products was measured via a functional assessment of product self-dosing and by testing patients' understanding of the risks of concomitant use (i.e., taking 2 products at the same time when contraindicated). Vision was assessed using the Rosenbaum vision chart and dichotomized as normal (visual acuity of 20/20-20/25) or low (acuity of 20/30-20/100). Bivariable and multivariable analyses were performed to determine the impact of visual acuity on medication misuse outcomes.

RESULTS: Among the study participants ( = 500), 39% had limited literacy, and 54% were categorized as having low vision. After controlling for age, race, and prior acetaminophen use, low vision was independently associated with an increased risk of self-dosing errors (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.25-2.21; < 0.001) and misunderstanding of concomitant-use risks (OR, 1.41; 95% CI, 1.00-2.00; = 0.05). Limited literacy was an independent risk factor for incorrect dosing (OR, 1.71; 95% CI, 1.25-2.35; = 0.001) and unawareness of concomitant use instructions (OR, 4.14; 95% CI, 2.80-6.12; < 0.001).

CONCLUSION: Misunderstanding of nonprescription acetaminophen product information was common among study participants and independently associated with both impaired visual acuity and low literacy skills.

}, year = {2018}, journal = {Am J Health-Syst Pharm}, volume = {75}, pages = {e213-e220}, month = {05/2018}, issn = {1535-2900}, doi = {10.2146/ajhp170303}, language = {eng}, }