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Labelling

Flag-labelling of eye-drops

From Ms A. F. James, MRPharmS

Keith Farrar and Julie Orton (PJ, April 7, 2001, p465) ask: “Does one label the medicines container or its package?” There is only one answer, and that is to label the container.

If it is stated in The Medicines (Labelling) Regulations 1976 and the Royal Pharmaceutical Society's “Medicines, ethics and practice” guide that it is the container and not the packaging that should be labelled, then that is what we should be doing. We have a professional duty to ensure that all medicines are clearly labelled, particularly eye products, because many patients using these will have less than perfect eyesight.

I am the only pharmacist in a busy eye hospital, where nearly all prescriptions are for eye-drops or ointment. I routinely “flag” all labels. I fold over a small flap at the bottom of the label so that the patient's name is visible on the front. I then cover both sides of the label with Sellotape, which stops the label sticking where it is not wanted, and keeps the instructions on the front from smudging. This also leaves a clear space on the back of the label where I attach a large-print auxiliary label with a simplified instruction on it, eg “LEFT FOUR” (left eye, four times daily). The print is black on yellow to make it easier for partially sighted people to see. This may, at first, seem time-consuming, but it is not. This is a busy hospital, and most outpatients get their medicines in under five minutes. Sticking the label around the bottle is no good, as not only does it obscure the manufacture's information, but also interferes with opening the bottle.

I disagree that the advantages of flag-labelling eye-drop bottles are outweighed by practical problems such as impairing patients' ability to use them. When we first started doing this several years ago, we surveyed the patients and found that most found this method of labelling helpful, especially the large-print auxiliary labels. If any patients say that they find the “flag” makes the bottle awkward to use, I advise them simply to secure it in place with an elastic band. This keeps it out the way, but ensures that the manufacturer's information can still be read if needed. I know that there are some patients who will tear off the labels, but at least I know that all medicines have left my pharmacy clearly and properly labelled.

Angela James
Princess Alexandra Eye Pavilion
Edinburgh

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