Who among us has not received prescription drugs in a container bearing more labels than a NASCAR vehicle has decals?

Information and warning labels are applied to medicine bottles and packages, the thinking goes, because it’s the most immediate, and therefore most effective, delivery system for patient safety information. Except that it’s not working, according to a recent study published in PLoS One.

The study found that only half of its participants looked directly at all of the warning labels; more than 1 in 5 didn’t look at any. This is rather alarming when you consider that approximately 4 million Americans experience adverse reactions to prescription medications every year. Some are relatively mild, such as minor rashes, but others can be fatal. The study’s researchers, from Michigan State University, concluded that many such events could be avoided if warning labels were more effective.

Researchers studied how two groups of patients—young adults and those older than 50—reacted to the small, colorful stickers applied at the pharmacy where the medicine was dispensed. They tracked patients’ eye movements when they got the drugs, and later tested their memory recognition about the information printed on the labels. The older group failed more often initially to read labels, but when they did, the age-related differences weren’t significant. That suggests that group differences were related not to the ability to remember, but to pay attention.

That’s important because older people are generally recognized to be at greater risk of an adverse drug event: On average, nearly 1 in 3 people older than 65 take 10 different medications daily.

“Given our results,” said Laura Bix, associate professor in MSU’s School of Packaging, “we are recommending a complete overhaul of the design and labeling of the ubiquitous amber bottles [and plastic containers], which have seen little change since their introduction some 50 years ago. Our initial recommendations would be to move all of the warnings from the colored stickers to the main, white label, which 100 percent of the participants read, or to reposition the warnings so that they can be seen from this vantage point.”

So if drug labels are better at capturing a consumer’s attention initially for warnings such as “do not consume alcohol while taking this medicine,” or “for external use only,” the risk of a problem drops.

Here’s where effective medicine crosses the boundary of biological science. MSU Mark Becker, assistant professor of cognition and cognitive neuroscience said, “By applying basic research on the control of attention to the design of labels, we may greatly improve their effectiveness.”

Until labels that effectively communicate important drug information become standardized across all forms of prescription packaging, anyone taking any drug—even one available over the counter—should read all labels and enclosures for every drug he or she takes. The only way to minimize the risk all medicines carry is to know as much as you can about how it behaves in your body, alone and when taken with other chemical compounds.