From Mrs V. J. Haylor, MRPharmS
SIR,—While being aware of the controversies surrounding the use of colour when marketing pharmaceuticals (PJ, September 4, 1999, p349, and October 30, p708) we should recognise that it is our professional duty to meet the needs of the patient. As a pharmacist working in a hospital eye department, I am particularly aware of the medication errors which arise with partially sighted patients.
I would suggest we should be encouraging representatives from industry and the pharmacy professions to reconsider ways in which current technology may help support clearer labelling and to promote the ease of differentiation between similarly packaged medicines.
There is no substitute for accurate reading of labels, however busy a nurse, doctor or pharmacist might be, but consideration is for the patient who is currently failing to manage their medicines at home. With Section 21 of the Disability Discrimination Act 1995 the partially sighted can expect to receive their medicines packaged and presented for ease of use and this should mean larger font print and adequate colour contrast on labels and information leaflets. Providers of labelling software and printers should be made aware that there is a need to meet legibility as well as legal standards.
At a recent meeting of the UK Ophthalmic Pharmacists Group an easier differentiation between unit dose eye-drops was called for.
The use of single dose products for patients allergic to preservatives means pharmacists are regularly supplying these for use at home and using coloured stickers or some other means at the point of dispensing to help the patient to differentiate, for example, their antibiotics from their steroids. This identification is lost, however, as soon as the unit is removed from the box. A spokesman from Chauvin Pharmaceuticals told the group that other countries, such as Canada, Finland, Norway and Sweden, insist on particular colours for each therapeutic category but there is no consistency due to lack of international standards. A uniform standard across the UK for ready package identification - as adopted for insulin - would be a positive move to help patients manage their medicines independently.
The Health Service circular covering aspects of ophthalmic preparations HSC(IS)122 is currently being reviewed and it is interesting to note that the original working party in 1975 suggested that there should be further consideration as to the desirability of colour coding and the possibility of advising on standardisation.
Perhaps it is time for the National Pharmaceutical Association and the Royal Pharmaceutical Society, working with patient groups, such as the Royal National Institute for the Blind and the International Glaucoma Association, to produce a standard for the UK which would direct manufacturers to comply with an established directive on package contrast at the point of production.
Val Haylor
Directorate Pharmacist (Ophthalmology), Royal Hallamshire Hospital, Sheffield