Pharmaceutical Pictograms Testing
2023
Testing and validating pharmaceutical pictograms through user research to improve clarity, usability, and cross-cultural understanding.
Under the guidance of Prof. Mandar Rane and Prof. Swati Pal
Fellow Researchers: Abhinav & Akash Nath
Agency
IIT Bombay
Tools
Google sheets
Adobe illustrator
Type
Researcher
Assessing Understanding of Pharmaceutical Pictograms Among Indian Audience
Pharmaceutical pictograms are simple pictures that show how to use medicines safely. They help people understand instructions without language barriers.
Goal: To assess how Indian users interpret standard pharmaceutical pictograms and identify patterns of misunderstanding.
Objective: To evaluate comprehension levels against the ISO 67% benchmark and uncover culturally driven misreading.
Why It Matters ?
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Pictograms improve medicine safety.
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Help non-readers and multicultural users.
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Avoid medication mistakes.
How we did it ?
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Each pictogram was first shown individually, and participants were asked a simple question: “What does this image represent?”. Their spontaneous interpretations were recorded.
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The same pictogram was then shown to 30 participants, generating a list of varied interpretations for each icon.
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This list was analysed to identify the most frequent meanings, which were narrowed down to three alternative interpretations plus the correct one to form multiple‑choice options.
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These options were used in the final survey, where participants selected one meaning per pictogram, allowing comprehension to be evaluated against the ISO‑3864 67% correctness threshold.
Selecting pictograms
Started with 50 USPC pharmaceutical pictograms and shortlisted 12 by evaluating frequency of use, difficulty of interpretation, criticality to patient safety, and method of administration.
The final set of pictograms spanned three categories: eight related to general information, three to precautions, and one to warnings.
Shape system and meanings
Pictogram selection matrix across ease, frequency, difficulty, criticality, and method criteria
Pilot study
Ran a pilot with 30 participants who freely described each pictogram in their own words.
Audience: 30 everyday users who were shown each pictogram and asked to describe what it meant in their own words.
Insights: Many pictograms were misunderstood, and several prompted multiple, conflicting interpretations, revealing how differently people read the same symbol.
All responses were grouped into meaning clusters, and for each pictogram the three most frequent alternative interpretations were chosen as options for the main survey.
Pictogram selection matrix across ease, frequency, difficulty, criticality, and method criteria
Sorting the options
Pilot responses were sorted and colour‑coded based on how close they were to the intended meaning, which made it clear where people aligned and where they went off track. From these clusters, the three most plausible alternative interpretations for each pictogram were chosen and later used as answer options in the main survey.
Pictogram selection matrix across ease, frequency, difficulty, criticality, and method criteria
Study
The main study was conducted in Mumbai, with a focus on shop owners and vendors, including many women working in the fish market. Participants chose their preferred language (mostly Hindi, with one Marathi participant), viewed pictograms on a smartphone, and selected from the prepared options while the team noted observations and logged all responses in an Excel sheet for analysis.
Key Findings
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Overall comprehension was below ISO (International Organization for Standardization) standard of 67%.
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Confusing doctor/patient symbols could risk miscommunication.
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Cultural differences impacted interpretation, such as arrows perceived differently.
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Lack of clear cues caused wrong assumptions (e.g., missing food symbol).
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Misinterpretation of critical icons poses patient safety risks.
Conclusion
This study revealed that the selected pharmaceutical pictograms did not meet the ISO 67% comprehension threshold for the Indian audience tested, raising concerns about their reliability in real‑world use.
Participants frequently misread critical icons, struggled to recognize roles like doctor and patient, and were strongly influenced by contextual cues such as plates, arrows, and familiar cultural references like tobacco and meditation. These patterns show that “universal” pictograms can become ambiguous or misleading when they are not validated in local contexts, especially in low‑literacy, multilingual environments.
Glossary & Abbreviations
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USP: United States Pharmacopeia – organization creating medicine standards.
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ISO: International Organization for Standardization – sets global quality and safety standards (67% comprehension is minimum for effective pictograms).
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FIP: International Pharmaceutical Federation – develops pharmaceutical pictograms.
