Pictogram: A Better Tool for Counselling Tuberculosis Patients on Medication Use, Diet, and Life Style Modifications

Relapse and spread of tuberculosis occurs due to lack of knowledge among the patients. India has 37% of the global total of illiterate patients. This emphasizes the need for developing effective tools to counsel patients according to their literacy level. So, we focus on developing pictograms which can be used to counsel even those TB patients with low literacy levels. To evaluate the role of pictograms in conveying information about medication use, diet, and life style modifications for TB patients and to develop a pictographic leaflet for counseling them. Study included patients with basic education diagnosed with respiratory diseases. In Phase I survey, the best out of 5 pictograms, which conveyed good understanding for each counselling point, were selected and modified. In Phase II, comprehensibility of these pictograms was tested using "guess-ability" and "translucency" studies. Best 56 pictograms out of 240 were selected by 20 pharmacists and 30 patients. 150 patients were enrolled in the guess-ability and translucency studies. Comprehensibility of pictograms did not vary based on gender, age group, or educational level. But differences existed for specific pictograms. Pictograms are generally well understood when the intended meanings were explained. Out of 56 pictograms, 26 passed the European Commission criteria. Pictograms play a vital role in educating patients irrespective of literacy. Pictographic leaflets can be used as an effective counseling aid in TB patients which help to improve compliance.