Effectiveness of pictograms in patients or caregivers in healthcare settings: A systematic review

Objectives: Pictorial representation has shown to be potential in enhancing patient knowledge. This study aimed to identify the usefulness of pictograms improving the knowledge of the patients or their caregivers. Key findings: The electronic databases such as PubMed, CINAHL, Embase and Scopus were searchedfor relevant studies. The Cochrane risk of bias tool was used to assess the quality of the included studies. The study was conducted following PRISMA guidelines. Pictograms were used alone or in combination with the text-based/written or verbal/ oral instructions of medication used in study intervention. All the included studies showed similar outcomes that had a positive impact on improving patient adherence and helped in decreasing the dosing error. Factors such as age, gender, literacy level had a negative impact on adherence. Pictograms had a positive impact on the adherence in patients with low health literacy levels than the written/oral interventions. Summary: The current review provided insights on the effectiveness of pictograms in patients or their caregivers of various age groups in healthcare settings. Future studies should be aimed to identify the knowledge gaps and barriers impacting the effectiveness of pictograms in various settings.