Date of Award

Winter 1-4-2020

Document Type


Degree Name



Department of Pharmacy Practice


Background: Pictograms are a graphical symbol that conveys a concept through its pictorial resemblance to a physical object, pictorial representation has shown to have a potential in enhancing patient knowledge. Methodology: The systematic review was conducted according to PRISMA guidelines. Randomized controlled trials including participants over 18 years older were included in the review. RCTs were included as it reduces certain type of bias by randomly allocating the participants. The risk of bias was assessed using Cochrane risk of bias tool, which assessed 5 different domains and scores were given according to their indication of low, high and unclear risk. The interventions included in these articles were pictograms with text or pictograms with verbal instructions and low literacy plan pictograms. Result: A total of 965 articles were retrieved through electronic searching, which went through first and second pass screening. Among which articles which did not meet the inclusion criteria were excluded. A total of 15 articles were included for the systematic review. All the included studies showed similar outcomes which said that pictograms had a positive impact on improving patient adherence to their respective medication and helped in decreasing dosing error. Factors such as age, gender, literacy level have a negative impact on adherence. Pictogram intervention improved adherence especially in patients with low health literacy levels than the written/oral interventions. Conclusion: The current review provided a brief literature on the effectiveness of pictogram in healthcare setting in patients or their caregivers of various age groups. Future studies should be aimed to identify the knowledge gaps and barriers impacting the effectiveness of pictogram for better patient education and safety.