Need a Magnifier to Read Your Prescription Labels?

Do you have problems reading the label on prescription vials or bottles? I admit I have a serious problem reading parts of the label. The prescription number, the dose, the number of refills, and the expiration date require using a magnifier. The instructions are easier to read and I seldom have problems with reading that. These are for prescriptions from my local pharmacy.

The prescriptions received from the VA pharmacy come with a printed sheet or sheets that are easy to read. The bottles or vials are readable for about three weeks and then the printing fades to totally unreadable. This fading is because of the oils from my hands and it does not take long to become unreadable. If I was not aware of the shape of the pill and color, it might be easy to mistake what the medication was and over use. Keeping the sheet with each bottle is not acceptable because it is too large to fit under the bottle and the bottles and vials constantly tip over and fall on the floor from the shelf.

That is why I have resorted to my own labels that are easier to read and larger in print size (font). Then I tape one side to the vial or bottle and leave the other side untaped.

Not the nicest looking, but at least I am able to read them. The paper is light enough and the vials seldom tip over until they are near empty and I have a set up to prevent this.

Now a study in Canada points to some of the problems I am having. The study published in the Canadian Pharmacists Journal, found that labels on prescription medications dispensed by pharmacies do not consistently follow recommended guidelines for legibility.

The study author, Dr. Sue Leat from Waterloo's School of Optometry and Vision Science, in Ontario, Canada, says there are few guidelines and no regulations for the print on prescription labels. She continues that what regulations there are specify only the content of prescription labels, not how they appear.

Researchers asked 45 pharmacies in three Canadian cities to print a sample prescription label with the patient's name, drug name, and use instructions. The sample label was then compared to label printing recommendations. The results showed that 44 percent of the labels met the minimum font size of 12 points. Half of

the labels were printed left justified and few of the recommendations for best use of spacing used.

All labels used capital lettering, which is difficult for patients with eye problems to read, instead of the recommended lettering. Over 90 percent of labels followed guidelines for font style, black print, and non-glossy paper. The research shows that font size and other factors can have an effect on readability of prescription labels.

The researchers plan to develop a prototype pharmaceutical label and test its readability and accuracy and use a questionnaire to survey pharmacists and patients (with and without visual impairments).

At least with my own labels, I can just make sure that the prescription number is updated and any other changes.

Guidelines and Those That Develop Them

When I read this by Dr Malcolm McKendrick, I had to think how like some other guideline committees I have written about lately. Dr. McKendrick writes about the group that wrote the cholesterol guidelines and how they attempted to hide the conflicts of interest that those on the guideline committee had. For that digging and forcing the issue, I hope that I am able to properly thank Dr. McKendrick someday.


This paragraph from Dr. McKendrick's blog really makes the point. “In 2004 this committee decided that cholesterol levels should be lowered far more aggressively than in the past. Based on, as far as I could see, very flimsy evidence. Could it be that that committee was, in some way, biased in favour of cholesterol lowering companies? A number of people, including me, demanded to see if any of the eight invited members of this hugely important committee had financial conflicts.”


Yes, they certainly did have financial conflicts and this has to mean that there needs to be more concern about statins our doctors insist that we consume.


This type of digging was necessary for the American Association of Clinical Endocrinologists diabetes algorithms issued on or before April 24, 2013. At first they did not give out any information about the algorithm, conflicts of interest, and missed many points. After a Medscape article and a New York Times article, they still took over a month to issue a consensus statement for the algorithms. Many points were still omitted because they won't accept them as being what happens in the real world. Yet many of us with type 2 diabetes know better and think that the members of the committee are out of touch with what happens outside their towers.


Members of our support group have been thinking that we are the fortunate ones to have doctors that do not completely align themselves with the AACE. We are in agreement that people with conflicts of interest have no business being on committees that develop algorithms or guidelines because we know the bias they bring to the discussions. Whether it is true or just supposition on our part, we feel that some of the conflicts result in extra fees for many of the committee members.


I personally feel that if they had issued a consensus statement with the algorithms, there may have been less criticism, but the criticism they received was well placed and pointed out the shortcomings of the algorithms. It showed us how incomplete the algorithms are in opposition to Dr. Garber's “comprehensive” statement.

More Criticism of the AACE Diabetes Algorithms

The American Association of Clinical Endocrinologists apparently likes to pick and chose its fights. They did not attack Anne L. Peters, MD, CDE, Professor of Clinical Medicine; Director, Clinical Diabetes Programs, Keck School of Medicine, University of Southern California, Los Angeles, California. Yet, they pulled out all stops to clash with Jerry Avorn, MD, Professor of Medicine at Harvard Medical School and Chief of the Division of Pharmacoepidemiology and Pharmacoeconomics in the Department of Medicine at Brigham and Women’s Hospital.

Therefore, I would be inclined to believe Dr. Avorn struck a raw nerve in his criticism of AACE's business ethics and they could not let that go without a denial for posturing position. Dr. Avorn stated in his New York Times op-ed piece, “The A.A.C.E.’s latest guidelines elevate many second- or third-line drugs to more prominent positions in the prescribing hierarchy, rivaling once uncontested go-to medications like metformin, an inexpensive generic. They also emphasize the riskiness of established treatments like insulin and glipizide, which now carry yellow warning.”

This is something to consider and I missed this point in my discussion here. Dr. Avorn also states in his New York Times op-ed piece, “But there is also concern that they could have been influenced by another factor: the manufacturers of some of these new drugs financially supported the development of the guidelines, and many of the authors are paid consultants to some of those companies.” I agree, as there was too little information published with the AACE Diabetes Algorithms and nothing stating how they were developed and if others had approved them. When something is just published with little additional information except some press and quotes from a Dr. Garber, criticism should be expected.

When you know that they have many corporate-partners in the pharmaceutical ranks, the denial of what Dr. Avorn says holds no water and clearly is done to appease the corporate ranks. Review the corporate-partners list here. If you carefully read this denial on the AACE website, they only deny corporate funding of the algorithms, but make no denial of the consulting fees paid by corporate-partners. There may have been a healthy bonus in their consulting pay. How else could these “experts” have, “Donated days of time and talent to accomplish what they value as an important component of public health.”