Risk minimisation patient cards in the UK and EU are educational tools designed to provide essential safety information to patients who have been prescribed high-risk medications. These cards aim to reduce adverse drug reactions, improve medication adherence, and enhance patient safety by clearly communicating key risks and precautions. They are typically issued for medications with significant safety concerns. These include teratogenic drugs, such as isotretinoin, blood thinners like warfarin, or immunosuppressants, such as methotrexate.

Despite their important role, many risk minimisation cards suffer from poor design, complex language, and ambiguous instructions. This can lead to confusion and improper use of medication. Here are 10 common mistakes found in these cards, along with examples and suggested improvements.

1. Complex medical jargon

Example:

“This medication is contraindicated in pregnancy due to teratogenic effects. Women of childbearing potential must adhere to strict contraceptive measures to prevent foetal exposure.”

Why is this a mistake?

• Terms like “contraindicated,” “teratogenic,” and “foetal exposure” are complex and may not be understood by all patients, such as those with low health literacy.

• “Women of childbearing potential” is a clinical term that could be confusing.

Suggested improvement:

“Do not use this medicine if you are pregnant or planning to become pregnant, as it can harm your baby. You must use reliable birth control while taking this medicine.”

2. Dosage Instructions that are ambiguous

Example:

“Take the prescribed dose as directed by your healthcare provider. Do not adjust the dosage without consultation.”

Why is this a mistake?

• It does not specify what to do if a dose is missed or if side effects occur.

• Patients might be unsure whether to take the dose later or skip it altogether.

Suggested improvement:

“Take one tablet once a day at the same time each day. If you miss a dose, skip it and take the next dose at the usual time. Do not take two doses at once to catch up.”

3. Emergency instructions that are vague

Example:

“Seek medical attention if serious adverse reactions occur.”

Why is this a mistake?

• It does not explain what symptoms to look for, or how quickly to act.

• “Serious adverse reactions” is vague and open to interpretation.

Suggested improvement:

“Go to A&E at your nearest hospital immediately if you have severe chest pain, difficulty breathing, swelling of your face or throat, or a severe rash.”

4. Warnings about interactions that are inconsistent 

Example:

“Avoid interactions with CYP3A4 inhibitors or inducers.”

Why is this a mistake?

• “CYP3A4 inhibitors or inducers” is pharmacological jargon that most patients will not understand.

• It does not specify which common medications or foods this would relate to.

Suggested improvement:

“Do not take this medicine with certain antibiotics, antifungals, or grapefruit juice. These can affect how this medicine works.”

5. Lack of clarity about specific instructions

Example:

“Effective contraception is required during and for 3 months after treatment.”

Why is this a mistake?

• “Effective contraception” is not clearly defined, leading to confusion about which methods are appropriate.

• It does not specify whether one or two methods are required.

Suggested improvement:

“You must use two forms of birth control, such as the contraceptive pill and condoms while taking this medicine and for 3 months after your last dose.”

6. Confusing dietary restrictions

Example:

“Avoid foods containing high levels of vitamin K.”

Why is this a mistake?

• It doesn’t specify which foods are high in vitamin K.

• Patients may not know how much is considered “high levels.”

• ‘Avoid’ is open to interpretation. People do not necessarily understand it as a prohibitive ‘do not’.

Suggested improvement:

“Do not eat large amounts of green leafy vegetables, such as spinach, kale, and broccoli. This is because they can affect how this medicine works.”

7. Poor Layout and Overcrowded Information

Example:

• Information is densely packed, with long paragraphs and no bullet points or headings.

• Important warnings are buried within blocks of text, making them easy to overlook.

Why is this a mistake?

• Readers may skim over the text or miss critical safety information.

• Crowded layouts are overwhelming and put people off from reading the whole text.

Suggested improvement:

• Organise information into clearly labelled sections

• Use bullet points, bold headings and plenty of white space for a cleaner, easier-to-read layout.

• 
  

8. Complex instructions for handling and disposal

Example:

“Dispose of unused medication according to local regulations to prevent environmental contamination.”

Why is this a mistake?

• It doesn’t specify how or where to safely dispose of the medication.

• “Environmental contamination” may not resonate with patients who are more concerned about immediate safety.

Suggested improvement:

“Do not throw this medicine in the bin or flush it down the toilet. Return unused medication to your pharmacy for safe disposal.”

9.  Icons and visuals that do not work very well

Example:

• Icons are used inconsistently or without clear labels, leading to confusion about their meaning.

• Small or overly stylised icons are hard to interpret, especially for older adults or those with degrees of sight loss.

Why is this a mistake?

• Misinterpretation of icons can lead to incorrect medication use or safety risks.

Suggested improvement:

• Use simple, universally, culturally neutral recognised icons, with clear labels or short explanations.

• Ensure high contrast and sufficient size for easy visibility.

10. Lack of cultural sensitivity or inclusivity

Example:

“Consult your doctor if you have concerns about pregnancy or contraception.”

Why is this a mistake?

• It assumes that all patients identify as female or are comfortable discussing reproductive health with a male healthcare provider.

• It may not consider cultural differences in discussing sexual health.

Suggested improvement:

“If you have questions about pregnancy prevention, speak to your doctor, pharmacist or nurse. You can ask for a female provider if you prefer.”

Recommendations:

• Use plain language: Do not use medical jargon and complex terminology. Use simple, direct language that can be easily understood by all patients.

• Be specific and detailed: Give clear, actionable instructions for dosage, timing, and emergency situations.

• Organise information logically: Use headings, bullet points, and sections to organise information clearly and logically.

• Include visual aids: Use clear, well-labelled icons and diagrams to help understanding, especially for complex instructions.

• Cultural sensitivity: Make the language and visuals culturally sensitive and inclusive.

• Consistency across all information channels: Ensure consistent messaging with patient leaflets and other educational materials.

• User Testing: Conduct user testing with a diverse patient population to ensure clarity, comprehension, and cultural relevance.

Thank you for reading!

Mark Gibson, Leeds, United Kingdom, March 2025