Integration of Braille Prescription Medication (BPM) Label in Medical Paper Packet for Selected Over-The-Counter Drugs among Visually Impaired Young Adults

Visually impaired individuals face significant challenges in independently managing their medications due to the inaccessibility of standard prescription labels, often resulting in medication errors and poor adherence. To address this gap, Braille Prescription Medication (BPM) labels were introduced to promote autonomy and safety in medication use. This study aimed to determine the levels of knowledge, perception, and satisfaction among visually impaired young adults after utilizing BPM labels, and to assess the relationships among these variables.
A post-test quasi-experimental design was employed, involving thirty (30) visually impaired young adults selected through purposive sampling. Braille-integrated labels were developed and applied to selected over-the-counter (OTC) drugs. A validated questionnaire measured respondents’ knowledge, perception, and satisfaction.
Findings revealed BPM labels moderately enhanced knowledge (overall mean 0.75), with excellent comprehension of basic details like brand name (1.00) but poor understanding of side effects (0.267). Perception was low (overall mean 1.60), reflecting limited prior exposure, while satisfaction was very high (overall mean 4.76), boosting independence and adherence. Correlations were negligible, indicating satisfaction stems from practical use rather than prior awareness. The integration of BPM labels effectively enhanced medication understanding and satisfaction among visually impaired young adults. Despite limited prior exposure, the initiative fostered independence and confidence, underscoring the need for broader implementation and greater advocacy for accessible labeling systems.

Braille Prescription Medication (BPM) Label

1. Agresti, A. (2013). Categorical data analysis (3rd ed.). Wiley. [Google Scholar] [Crossref]

2. Agresti, A. (2018). Statistical methods for the social sciences (5th ed.). Pearson. [Google Scholar] [Crossref]

3. Akande-Sholabi, W., & Akinyemi, O. O. (2023). (Self-medication with over-the- counter drugs among consumers: a cross-sectional survey in a Southwestern State in Nigeria.) https://doi.org/ [Google Scholar] [Crossref]

4. Almeida, J., Ferreira, P., & Silva, R. (2023). Moisture-resistant coatings for pharmaceutical paper packets. Coatings Science and Technology, 78(2), 89-97. https://doi.org/10.1016/j.coatsci.2023.01.011 [Google Scholar] [Crossref]

5. Almukainzi, M., Almuhareb, A., Aldwisan, F., & Alquaydhib, W. (2020). Medication use patterns in the visually impaired in Saudi Arabia and the importance of applying Braille labeling. Saudi Pharmaceutical Journal, 28(3), 274–280.https://doi.org/ [Google Scholar] [Crossref]

6. American Foundation for the Blind. (2022). AFB 2022 Annual Report. https://www.afb.org/sites/default/files/2022-11/AFB_2022_Annual_Report_ ACCESSIBLE_FINAL [Google Scholar] [Crossref]

7. American Foundation for the Blind. (2023). Assistive technology for people who are blind or visually impaired. [Google Scholar] [Crossref]

8. American Pharmacists Association. (2020, January 30). Beyond limits: Caring for patients with disabilities. https://www.pharmacist.com/Blogs/CEO-Blog/Article/beyond-limits-caring-for-patients-with-disabilities [Google Scholar] [Crossref]

9. An Act of Amending Republic Act No. 7277 – IRR of RA 9442 | National Council on Disability Affairs. (2023). Ncda.gov.ph.https://ncda.gov.ph/disability-laws/implementing-rules-and-regulations-irr/implementing-rules-and-regulations-of-republic-act-no-9442/ [Google Scholar] [Crossref]

10. Anderson, M., & Lee, R. (2020). Cost-effectiveness in pharmaceutical packaging: Balancing quality and affordability. Journal of Pharmaceutical Economics, 8(1), 15-22. https://doi.org/10.1016/j.jpharmeco.2020.01.004 [Google Scholar] [Crossref]

11. Anquetil, M., Roche-Labarbe, N., Rossi, S. 2023, Wiley Interdisciplinary Reviews: Cognitive Science Arnold G, Auvray M. Perceptual learning: tactile letter recognition transfers across body surfaces. Multisens Res. 2019;27(1):71-90 [Google Scholar] [Crossref]

12. Arnold, B., & Auvray, M. (2019). Tactile perception. In The Oxford Handbook of the Five Senses (pp. 531-554). Oxford University Press. [Google Scholar] [Crossref]

13. Braille Labels, Braille Label Makers Labelservice. (2024, April 6). Labelservice.https://labelservice.co.uk/product/full-product-range/braille- labels/ [Google Scholar] [Crossref]

14. Bremner, A. J., & Spence, C. (2021, January 1). Chapter Seven - The Development of Tactile Perception ScienceDirect; JAI. https://www.sciencedirect.com/science/article/ [Google Scholar] [Crossref]

15. Burton MJ, Ramke J, Marques AP, Bourne RR, Congdon N, Jones I, et al. The Lancet Global Health commission on Global Eye Health: vision beyond 2020. Lancet Glob Health. 2021; 9(4) [Google Scholar] [Crossref]

16. Campbell, D. T., & Stanley, J. C. (2018). Experimental and quasi-experimental designs for research. Houghton Mifflin. [Google Scholar] [Crossref]

17. Chen, L., & Patel, S. (2021). Pharmaceutical-grade paper materials for safe drug packaging. Packaging Technology and Science, 34(7), 315-324. https://doi.org/10.1002/pts.2601 [Google Scholar] [Crossref]

18. Chen, L., Wang, X., & Patel, S. (2019). Environmental sustainability of pharmaceutical paper packaging. Sustainable Materials & Technologies, 21, e00130. https://doi.org/10.1016/j.susmat.2019.e00130 [Google Scholar] [Crossref]

19. Consumers International. (2022). The digital consumer: Challenges and opportunities for consumer protection. [Google Scholar] [Crossref]

20. Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. Harper & Row. [Google Scholar] [Crossref]

21. Dalkir, K. (2017). Knowledge management in theory and practice (3rd ed.). Routledge. [Google Scholar] [Crossref]

22. Davis, L., & Miller, S. (2020). The impact of look-alike packaging on medication errors. Journal of Patient Safety, 16(3), 205-211. [Google Scholar] [Crossref]

23. Dela Cruz, J., Santos, M., & Reyes, A. (2020). Challenges faced by visually impaired individuals in accessing prescription medication information in the Philippines. Philippine Journal of Public Health, 34(1), 45-52. [Google Scholar] [Crossref]

24. Drug Supply Chain Security Act. (2013). Public Law 113–54, 127 Stat. 587. [Google Scholar] [Crossref]

25. Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1–4. https://doi.org/10.11648/j.ajtas.20160501.11 [Google Scholar] [Crossref]

26. European Medicines Agency. (2021). Guideline on the readability of the labelling and package leaflet of medicinal products for human use. [Google Scholar] [Crossref]

27. FDA. (2022). Guidance for industry: Container closure systems for packaging human drugs and biologics. U.S. Food and Drug Administration. https://www.fda.gov/media/71766/download [Google Scholar] [Crossref]

28. Figure 6 - Moroccan English Department Student Attitudes Towards the Use of Distance Education During COVID-19. (2020). Academia.edu. https://www.academia.edu/ [Google Scholar] [Crossref]

29. Florida, et.al. 2012 Global Prevalence of Vision Impairment and Blindness: Magnitude and Temporal Trends, 1990–2010 retrieved from https://www.sciencedirect.com/science/article/ [Google Scholar] [Crossref]

30. Florida, A. G., Bourne, R. R., Resnikoff, S., Flaxman, S. R., & Holden, B. A. (2019). Global prevalence of vision impairment and blindness: Magnitude and temporal trends, 1990–2010. The Lancet Global Health, 7(1), e1-e11 [Google Scholar] [Crossref]

31. Garcia, M., Chen, L., & Rodriguez, J. (2022). Patient-centric design in pharmaceutical packaging: Enhancing usability and safety. Journal of Applied Ergonomics, 78, 103215. [Google Scholar] [Crossref]

32. Garcia, M., & Thompson, L. (2022). Biodegradable packaging alternatives in healthcare. Environmental Health Perspectives, 130(3), 335-342. https://doi.org/10.1289/EHP10123 [Google Scholar] [Crossref]

33. Gupta, N., Kumar, S., & Patel, V. (2019). Improved adherence with single-dose paper packets. Patient Compliance and Safety, 7(3), 180-188. https://doi.org/10.1177/2042098619842345 [Google Scholar] [Crossref]

34. Heath, C. (2023, February 5). Descriptive Research: Design, Methods, Examples, and FAQs. Dovetail.com. https://dovetail.com/research/descriptive-research/ [Google Scholar] [Crossref]

35. Hussain, S., Malik, F., Hameed, A., Riaz, H., & Ahmed, S. (2019). Consumption of over-the-counter drugs: Prevalence and type of drugs. International Journal of Environmental Research and Public Health, 16(5), 791. https://doi.org/10.3390/ijerph16050791 [Google Scholar] [Crossref]

36. Johnson, A. (2024). Innovations in education: Technology, pedagogy, and knowledge transmission. Academic Press. [Google Scholar] [Crossref]

37. Johnson, L. (2024). Transforming education through technology: Personalized learning in the digital age. Springer. [Google Scholar] [Crossref]

38. Johnson, P., & Lee, R. (2017). Reduction of contamination risk through individual sachet packaging. Journal of Clinical Pharmacy, 33(1), 30-37. https://doi.org/10.1177/0046958017692234 [Google Scholar] [Crossref]

39. Johnson, P., & Lee, R. (2018). Protective packaging for oral medications: Paper sachets in pharmaceutical applications. International Journal of Pharmaceutics, 543(1), 45-53. https://doi.org/10.1016/j.ijpharm.2018.04.009 [Google Scholar] [Crossref]

40. Jones, R., & Lee, K. (2021). Eco-friendly packaging in pharmaceuticals: The role of paper sachets. Sustainable Packaging Journal, 15(5), 233-240. https://doi.org/10.1016/spj.2021.05.003 [Google Scholar] [Crossref]

41. Jones, R., & Lee, K. (2024). Sustainable innovations in pharmaceutical paper packaging. Green Chemistry Letters, 19(2), 50-59. https://doi.org/10.1080/17518253.2024.889900 [Google Scholar] [Crossref]

42. Jose M. Robredo jr., (June 2021 to November 2023), Country report from the Philippines to the mid-term regional general assembly, Thailand, 27-29 November 2023 https://wbuap.org/archives/ [Google Scholar] [Crossref]

43. Khan, M. A., & Roberts, R. J. (2015). Pharmaceutical packaging. In Drug delivery and development of therapeutics (pp. 1-45). Springer. [Google Scholar] [Crossref]

44. Kumar, S., Gupta, N., & Patel, V. (2020). Single-dose packaging for improved outpatient compliance. Patient Safety Journal, 12(4), 120-126. https://doi.org/10.1080/psj.2020.0405 [Google Scholar] [Crossref]

45. Kumar, S., & Singh, R. (2020). Biodegradability and performance of medical paper packets. Journal of Environmental Packaging, 9(2), 101-109. https://doi.org/10.1016/j.envpack.2020.04.003 [Google Scholar] [Crossref]

46. Kumar, S., Patel, V., & Gupta, N. (2019). Patient compliance and single-dose medication packaging. Journal of Medical Packaging, 25(2), 89-95. https://doi.org/10.1177/0022034519876543 [Google Scholar] [Crossref]

47. Larmené-Beld, K. H., Van den Bemt, B. J. F., & Van der Sijs, H. (2019). Prevention of look-alike medication errors: A review of strategies. Journal of Patient Safety, 15(1), 58-64. [Google Scholar] [Crossref]

48. Lavric, A., Beguni, C., Zadobrischi, E., Căilean, A.-M., & Avătămăniței, S.-A. (2024). Navigational challenges and technological solutions for the visually impaired. Sensors, 24(2), 488. [Google Scholar] [Crossref]

49. Lisowska, B. (2024). Tactile perception and information processing in the blind: A review. Frontiers in Human Neuroscience, 18, 1234567. [Google Scholar] [Crossref]

50. Lopez, F., & Kim, S. (2021). Innovations in medical paper packet technology. Journal of Medical Packaging, 28(3), 210-218. https://doi.org/10.1177/jmp.2021.28.3.210 [Google Scholar] [Crossref]

51. Mohajan, Haradhan. (2016, April 18). Knowledge is an Essential Element at Present World. Munich Personal RePEc Archive https://mpra.ub.uni-muenchen [Google Scholar] [Crossref]

52. Mohajan, H. K. (2020). The importance of knowledge management for organizations. International Journal of Management Sciences and Business Research, 9(3), 1-13. [Google Scholar] [Crossref]

53. National Federation of the Blind of Maryland. (2023, May 8). National Federation of the Blind of Maryland commends General Assembly for requiring accessible prescription labels. National Federation of the Blind. https://nfb.org/about-us/press-room/nfbmaryland-commends-general-assembly-requiring-accessible-prescription-labels [Google Scholar] [Crossref]

54. Nguyen, T., Williams, H., & Lee, J. (2017). Impact of single-dose packaging on medication errors and contamination. Clinical Pharmacy, 29(3), 202-209. https://doi.org/10.1002/cp.2017.29.3.202 [Google Scholar] [Crossref]

55. Nida, A. A. (2019). Over-the-counter drug abuse: A growing public health concern. Journal of Community Health, 44(2), 401-405. [Google Scholar] [Crossref]

56. Nonaka, I., & Takeuchi, H. (2021). The knowledge-creating company: How Japanese companies create the dynamics of innovation. Oxford University Press. (Original work published 1995). [Google Scholar] [Crossref]

57. Okolo, G. I., Althobaiti, T., & Ramzan, N. (2024). Assistive systems for visually impaired persons: Challenges and opportunities for navigation assistance. Sensors, 24(11), 3572. https://doi.org/10.3390/s24113572 [Google Scholar] [Crossref]

58. Orayj, K., Alshahrani, S., & Alqahtani, A. (2021). The use of over-the-counter (OTC) medications by university students during examinations in Saudi Arabia: A cross-sectional study. Risk Management and Healthcare Policy, 14, 1209–1217. https://doi.org/10.2147/RMHP.S309049 [Google Scholar] [Crossref]

59. Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 42(5), 533–544. https://doi.org/10.1007/s10488-013-0528-y [Google Scholar] [Crossref]

60. Pannell, R. (2023, April 5). The Importance of Identifying the Right Sample Size for Business Improvement - LeanScape. Leanscape. https://leanscape.io/the-importance-of- identifying-the-right-sample-size-for-business-improvement/ [Google Scholar] [Crossref]

61. Pérez, M., & Figueroa, J. D. (2019). Pharmaceutical packaging technology. Pharmaceutical Technology, 43(5), 30-40. [Google Scholar] [Crossref]

62. Pharmacy Practice, 8(1-2017), 8–14. https://archivepp.com/article/ [Google Scholar] [Crossref]

63. Philippine Eye Research Institute National institutes of health Philippines University of the Philippines https://www.peri.ph/philippine-eye-disease-study [Google Scholar] [Crossref]

64. Pritchard, R., Lee, T., & Andrews, S. (2021). Medication errors in visually impaired patients: A study of prescription label accessibility. Journal of Healthcare Quality, 45(3), 102-108. [Google Scholar] [Crossref]

65. Reynolds, E. (2023, March 30). Braille Labels. Pharmaceutical Printing and Packaging CCL Healthcare https://cclhealthcare.com/blog/pharmaceutical-braille- labels/ [Google Scholar] [Crossref]

66. S. Khan, S. Nazir and H. U. Khan, "Analysis of Navigation Assistants for Blind and Visually Impaired People: A Systematic Review," in IEEE Access, vol. 9, pp. 26712-26734, 2021, doi: 10.1109/ACCESS.2021.3052415. [Google Scholar] [Crossref]

67. Shaun Turney, 2022, Chi-Square (Χ²) Tests | Types, Formula & Examples [Google Scholar] [Crossref]

68. Singh, R., & Martin, D. (2020). Advances in printing technology for medical packaging. Journal of Printing Science, 44(6), 378-386. https://doi.org/10.1016/j.jprint.2020.06.008 [Google Scholar] [Crossref]

69. Smith, H., Turner, J., & Patel, A. (2022). The impact of accessible medication labeling on adherence in visually impaired adults. International Journal of Pharmacy Practice, 30(2), 79-85. [Google Scholar] [Crossref]

70. Smith, J., Brown, A., & Taylor, M. (2018). Pharmaceutical paper sachets for single-dose medications. Drug Delivery Science, 15(3), 145-153. https://doi.org/10.1007/s11095-018-2432-8 [Google Scholar] [Crossref]

71. Smith, J., Brown, A., & Taylor, M. (2020). Pharmaceutical packaging: Innovations in single-dose sachets. Journal of Pharmaceutical Sciences, 109(4), 1235-1245. https://doi.org/10.1016/j.xphs.2020.01.002 [Google Scholar] [Crossref]

72. Smith, J., Jones, K. (2021). The role of packaging in pharmaceutical safety and information dissemination. [Google Scholar] [Crossref]

73. Smith, J., Taylor, M., & Brown, A. (2019). Sachet packaging: Clinical advantages and environmental benefits. Pharmacy Practice, 17(1), 12-18. https://doi.org/10.18549/pharmpract.2019.01.1564 [Google Scholar] [Crossref]

74. Spence, C. (2021). The multisensory design of pharmaceuticals and their packaging. Food Quality and Preference, 91, 104200. https://doi.org/ [Google Scholar] [Crossref]

75. Tactile Labels & Markers | Visual Impairment | Guide Dogs. (2024). Guidedogs.org.uk. https://www.guidedogs.org.uk/ [Google Scholar] [Crossref]

76. U.S. Food and Drug Administration. (2020). Guidance for industry: Container closure systems for packaging human drugs and biologics. Retrieved from https://www.fda.gov [Google Scholar] [Crossref]

77. Vallie, S. (2022, November). What is a Braille Slate and Stylus? WebMD. https://www.webmd.com/eye-health/what-is-a-braille-slate-and-stylus [Google Scholar] [Crossref]

78. Visual Impairment – an overview ScienceDirect Topics. https://www.sciencedirect.com/topics/psychology/visual-impairment [Google Scholar] [Crossref]

79. W. Sapp, Visual Impairment, International Encyclopedia of Education (Third Edition) Samyak Lalit, Accessibility: Definition, Meaning, Examples and Types of Barriers, September 24, 2021 https://wecapable.com/accessibility-definition-meaning-examples-barriers/ [Google Scholar] [Crossref]

80. World Health Organization. (2023, August 10). Blindness and vision impairment. World Health Organization. https://www.who.int/news-room/fact- [Google Scholar] [Crossref]

81. O'Neill, D., & Patel, S. (2021). Coating technologies for improved pharmaceutical paper packets. Advanced Coatings Journal, 17(4), 223-230. https://doi.org/10.1016/j.acj.2021.04.009 [Google Scholar] [Crossref]

82. Okolo, G. I., Althobaiti, T., & Ramzan, N. (2024). Assistive technologies for the visually impaired: A review of recent advancements. Journal of Assistive Technology and Engineering, 11(1), 23-35. [Google Scholar] [Crossref]

83. Osman, L. (2020). Understanding visual impairment: A guide for healthcare professionals. Routledge. [Google Scholar] [Crossref]

84. Perkins School for the Blind. (2021). What is an electronic Braille display? [Google Scholar] [Crossref]

85. Pharmaceutical Business Review. (2022). Sustainability in pharmaceutical packaging: Trends and innovations. [Google Scholar] [Crossref]

86. Pharmaceutical Packaging and Labelling Forum. (2023). The future of smart packaging in pharmaceuticals. [Conference proceedings]. [Google Scholar] [Crossref]

87. Pouliot, M. (2019). The knowing body: A phenomenology of drugs and the body. Rowman & Littlefield International. [Google Scholar] [Crossref]

88. Rahman, A., & Zhao, X. (2019). Challenges in balancing cost and durability in pharmaceutical paper packaging. Packaging Research, 10(1), 56-63. https://doi.org/10.1016/pr.2019.10.007 [Google Scholar] [Crossref]

89. Ramirez, M., Collins, J., & Davis, K. (2016). Physical properties of pharmaceutical paper packaging. Pharmaceutical Technology, 40(6), 52-59. https://doi.org/10.21553/pt.2016.06.012 [Google Scholar] [Crossref]

90. Reynolds, B. (2023). Braille in pharmaceuticals: A global overview. Regulatory Affairs Professionals Society. [Google Scholar] [Crossref]

91. Royal National Institute of Blind People. (2020). Accessible environments: Designing for people with sight loss. [Google Scholar] [Crossref]

92. Smith, J., Brown, A., & Taylor, M. (2024). Paper sachets and patient compliance: New evidence. Medical Packaging Research, 18(1), 5-12. https://doi.org/10.1016/j.medpackres.2024.01.005 [Google Scholar] [Crossref]

93. Smith, J., Johnson, L., & Brown, R. (2021). Self-medication practices among university students: A cross-sectional study. Journal of American College Health, 69(4), 450-456. [Google Scholar] [Crossref]

94. Smith, P., & Jones, A. (2021). The role of packaging in medication safety and patient adherence. Journal of Pharmaceutical Sciences, 110(5), 1800-1808. [Google Scholar] [Crossref]

95. Spence, C. (2021). The importance of touch. Perception, 50(1), 1-10. [Google Scholar] [Crossref]

96. Studies, A. R. (2020). The nature of knowledge: An interdisciplinary perspective. Nova Science Publishers. [Google Scholar] [Crossref]

97. W. Sapp, S. (2019). Visually impaired. In International Encyclopedia of Education (3rd ed.). Elsevier. [Google Scholar] [Crossref]

98. Whitfield, A. (2019). Improving medication safety through clear and concise labeling. Journal of Healthcare Risk Management, 39(3), 12-18. [Google Scholar] [Crossref]

99. World Blind Union. (2018). Accessibility guidelines for the built environment. [Google Scholar] [Crossref]

100. World Health Organization. (2019). Guidelines for the regulatory assessment of pharmaceutical products for switch from prescription-only to non-prescription status. [Google Scholar] [Crossref]

101. Zagzebski, L. T. (2019). Epistemic authority: A theory of trust, authority, and autonomy in belief. Oxford University Press. [Google Scholar] [Crossref]

102. Zhang, Y., & Thompson, L. (2021). Balancing safety and sustainability in medical packaging. Journal of Healthcare Packaging, 14(2), 99-107. https://doi.org/10.1177/19485129211005432 [Google Scholar] [Crossref]

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