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Medication Guides are paper handouts that come with many prescription medicines. The guides address issues that are specific to particular drugs and drug classes, and they contain FDA-approved information that can help patients avoid serious adverse events. FDA requires that Medication Guides be issued with certain prescribed drugs and biological products when the Agency determines that: Medication Guides are found within drug labeling - the section is usually located at the end of the drug label although this is not always the case. Note that the links in the Medication Guides database go directly to the first page of the Medication Guide within the drug label. Please check the number of Medication Guide pages before printing.

The medication guides provide streamlined information on the administration of biologic, antiresorptive, and other medications used to treat patients with rheumatic disease. They also contain alerts about drug supply changes, applicable dosing calculators, and links to the manufacturers’ full prescribing information and patient guide. The guides were developed to assist registered nurses (RNs), health professionals new to rheumatology, or those who need basic information about the agents. If you are a patient, please consult your rheumatologist or health professional for medical advice, diagnosis, and treatment for your unique medical condition. For more details on how working with a rheumatologist can help you live well with rheumatic disease, read our article on the importance of following your treatment plan.

There is no satisfying the great thirst of the layman for medical information and medical action. To this end we have much of the energy of the Boy Scout movement directed at first aid, courses on hygiene and health in grammar schools, a great host of medical articles written for the laymen in popular lay journals, and a vast and growing collection of medical books by physicians addressed to the laymen. Any medical book which declares itself complete is sure to be out of date before it has gone to press. Though this is true of a book for laymen, it is not so important, for probably there will be no new medical information based on any current discovery which the laymen should have to save his life.

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For more than a decade, the Food and Drug Administration (FDA) has required ‘medication guides’ (med guides) be issued to consumers for prescription medications viewed to possess “serious and significant public health concerns.1,2” These industry-developed, FDA-approved print materials are distributed by pharmacies at the time of medication dispensing with the intent that they be read by patients prior to taking a prescribed drug. They provide specific dosing administration instructions that could prevent serious adverse effects associated with taking the medication, warn individuals about significant health risks that could affect one’s decision to take the medication, and underscore the importance of taking the prescribed medication to the patient’s health, and the need for proper adherence.

Med guides have become an essential part of risk evaluation and mitigation strategies (REMS).3–6 REMS are FDA-required, detailed pharmaceutical company plans for directly communicating the safe use of and risks associated with a certain drug to both prescribers and consumers. Prior investigations have repeatedly found that physicians and pharmacists miss opportunities to counsel patients on appropriate use of prescribed medicines,7–10 so med guides remain a frontline and often sole channel for conveying risk information to patients.

There has been increasing criticism of the efficacy of med guides to help patients, as a limited number of studies have suggested that there are problems with their format, clarity of content, and manner in which they are disseminated.11–13 Despite a 1996 Department of Health & Human Services memorandum that established readability standards for health materials,14 we found in our earlier research that the majority of med guides are too complex and written at a reading grade level not suitable for the majority of patients to comprehend.12 Consequently, only one in four patients reported attending to these materials.12 Shrank and colleagues also found that a required med guide was never distributed along with a prescription in observed prescription fills at pharmacies nationwide.15 Few studies to date have assessed patients’ ability to comprehend information contained in med guides, especially those with limited literacy. As the FDA is now aggressively investigating potential improvements and expansion of the med guides program,16–19 evidence we can provide detailing individuals’ comprehension of the information could serve as a valuable baseline for later program evaluations. We therefore sought to document the prevalence of misunderstanding med guides and provide a systematic evaluation of their current content and format. We conducted two complementary investigations: 1) a readability and suitability assessment of med guides, and 2) comprehension testing among primary care adult patients. We hypothesized that med guides would have an unacceptable level of reading difficulty and accessibility, and patients’ comprehension would be low; those with limited literacy would be at greatest risk for not being able to read and understand the materials successfully.