Fikriye YILMAZ, Zelal ÖZYILDIZ, Deniz GÜNGÖR ÖZCAN
Acta Pharmaceutica Sciencia - 2026;64(3):407-423
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.
