A short-term cohort study on comprehension and recall of United States Pharmacopeia pharmaceutical pictograms among Spanish adolescents

Objectives To explore the recall of United States Pharmacopeia pharmaceutical pictograms among Spanish adolescents completing formal education, with an emphasis on evaluating the impact of prior exposure on their comprehension. Methods A cohort study was conducted among 62 secondary education students during the 2021–2022 academic year. Two sessions were conducted: an initial assessment of pictogram comprehension and a recall assessment after 4 weeks. The evaluation of pictograms from the United States Pharmacopeia was conducted in compliance with the International Organization for Standardization 9186-1 standard. Statistical analyses included McNemar’s tests for paired proportions and a one-way repeated measures analysis of variance to compare comprehension rates between sessions. Key findings The mean comprehension rate increased from 68.35% in the transparency test to 80.57% in the recall test, representing a significant improvement (P = 0.041). Specific pictograms, such as ‘Do not use additional salt’ (P = 0.003) and ‘Do not take other medicines with this medicine’ (P = 0.001), demonstrated significant improvements in recall, while others did not show notable changes. Conclusions Prior exposure was found to significantly enhance the recall of pharmaceutical pictograms among adolescents. The implementation of a dual strategy combining visual aids and educational interventions is recommended to optimize the use of pictograms and support proper medication use among future end-users.