My life has been blessedly free of the need for pharmacological intervention, but I recently went for a checkup and left with a fistful of prescriptions. Because this routine drug-taking was sort of new to me, I actually read the inserts that came with the several prescriptions because, well, perhaps there was something I needed to know.
The text was hard for me to read, but that was only because it was in such small print—8 points, perhaps less. And there was quite a lot of it. But this technological limitation at aside, I was surprised at how readable the words themselves proved to be. Perhaps—and this is my observation—by design?
Some details. There are about 1230 words in all, which is about two and a half pages. The text is printed in blobs, aka “walls of text.” The only formatting is ALL CAPS and ALL CAPS IN BOLD. The text is not laid out with an eye to scannability. You can get an idea from the following, with a US quarter coin (about 1 inch/24 mm) for scale.
But as I read the text, I noticed that it seems written for clarity. Here’s an example:
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely. Take this drug at the same time of day. Take with or without food. Keep taking this drug as you have been told by your doctor or other health care provider, even if you feel well.
I noticed these things:
- Sentences are short.
- Words are (for the most part) simple and direct.
- Instructions are clear and are written as imperatives.
- The text anticipates possible reader questions (“… even if you feel well”).
The headings for the text—the ALL CAPS bits—either lead the reader toward instructions or function as a kind of FAQ:
Ingredient name (includes a pronunciation guide!)
Before using this medicine
What do I need to tell my doctor before I take this drug?
Tell your doctor if …
Tell your doctor if …
Tell your doctor if …
How to use this medicine
How is this drug best taken?
How do I store and/or throw out this drug?
What do I do if I miss a dose?
Possible side effects
What are some side effects that I need to call my doctor about right away?
What are some other side effects of this drug?
It’s not perfect (I’d certainly edit this a bit), but I think a lot of work went into deciding what information to put into this text, how to organize it, and how to phrase it. The result, I think, ends up being pretty readable.
So-called readability scores aren’t considered particularly precise, but I ran the text through Word’s readability checker and got these results:
The averages in the middle are the ones that seem significant to me:
- An average of 13 words per sentence is great. A study from 2008 suggested that comprehension dips below 90% when sentence are longer than 14 words. (And many sentences in the text are shorter than that.)
- The average of less than 5 characters per word is also good. This is supposed to index the proportion of monosyllabic—hence “simpler”—words.
The “reading ease” score of 78 is good (out of 100), and of course the “grade level” score of 5.4 is likewise is supposed to tell you that this text is intended to have the same readability as a text aimed at 10-year-olds. (All of this, let us remember, supposedly.)
But the numbers are only an imperfect way of capturing what I think is going on here, namely that the text has been designed to be comprehensible to as many readers as possible. The whole setup of providing instructions for drugs works against the pharmacist and other interested parties. The medium is bad (a printed insert in a prescription bag). A lot of people don't want to read this type of text. Some of the patients might not be strong readers. So the people who created this text tried to distill the information to the essentials and to present them as clearly as possible.
By the way, it doesn’t escape me that this text was almost certainly not written-written; it was probably assembled. I’m sure there’s a database of “drug insert text,” and a computer pulls out individual sentences to create text that’s relevant for a specific drug, and then prints it along with the labels for the pill bottles and the other stuff that’s stuck into the bag. Nonetheless, the result mostly works; not in layout, but in terms of the text itself. I give this a good grade and salute the many people who probably spent a long time putting this whole system together.