**How to Create a Pill Card**

**Prepared for:**

Agency for Healthcare Research and Quality

U.S. Department of Health and Human Services

540 Gaither Road

Rockville, MD 20850

[www.ahrq.gov](http://www.ahrq.gov/)

**Contract No. 290-00-0011**

**Prepared by:**

**The Pharmacy Intervention for Limited Literacy (PILL) Study Research
Team**

*Investigators*

Kara L. Jacobson, M.P.H., C.H.E.S.

Sunil Kripalani, M.D., M.Sc.

Julie A Gazmararian, Ph.D., M.P.H.

Karen J. McMorris, B.A.

**AHRQ Publication No. 08-M016**

**February 2008**

This user's guide was produced under contract to the Agency for
Healthcare Research and Quality (AHRQ) under Contract No. 290-00-0011
T07. The AHRQ Task Order Officer for this project was Cindy Brach,
M.P.P. The Robert Wood Johnson Foundation provided funding for this
guide. The Robert Wood Johnson Foundation Program Officer was Pamela S.
Dickson, M.B.A.

The findings and conclusions in this document are those of the authors,
who are responsible for its contents; the findings and conclusions do
not necessarily represent the views of AHRQ, the U.S. Department of
Health and Human Services, or the Robert Wood Johnson Foundation.
Therefore, no statement in this guide should be construed as an official
position of AHRQ, the U.S. Department of Health and Human Services, or
the Robert Wood Johnson Foundation.

Citation: Jacobson KL, Kripalani S, Gazmararian JA, McMorris KJ. How to
Create a Pill Card. (Prepared under contract No. 290-00-0011 T07.) AHRQ
Publication No. 08-M016. Rockville, MD: Agency for Healthcare Research
and Quality. February 2008.

**How to Create a Pill Card**

Use this guide to find out how you can create an easy-to-use "pill card"
for your patients, parents, or anyone you know who has a hard time
keeping track of their medicines.

**Why Create a Pill Card?**

Many people have trouble keeping track of their medicines. A pill card
is a simple, visual way to show all of the medicines that a person needs
to take on a regular basis. Medicines taken "as needed" should not be
included on the pill card since they do not follow a regular daily
schedule. The pill card uses pictures and simple phrases to show each
medicine, its purpose, how much to take, and when to take it. It is
easier to understand than the complicated information and instructions
that typically come with medicines.

This guide provides step-by-step instructions for creating a pill card
for a pretend patient, Sarah, who takes simvastatin, furosemide, and
insulin.

**What You Will Need to Create a Pill Card:**

1.  A computer with word processing software

2.  A color printer (note: the pill card may also be printed on a black
    and white printer and colored in by hand after printing)

3.  Information for all of the medicines that you wish to include on the
    pill card

4.  The actual medicines that you wish to include on the pill card

    **Getting Ready to Create a Personalized Pill Card**

    Before we start to create the actual card, we need to organize the
    medicine information that we want to include on the card and find
    pictures to represent the information.

We will create a table to organize all of the information. This table
includes:

-   the name of each medicine,

-   how much of each medicine (the dose) and what it does, which can be
    found on the package insert or bottle label, and

-   suggestions for ways to show this information using pictures.

Use this table as a guide to create your own outline of the information
that you want to include on the card for each medicine. The template
provided on page 9 includes pictures to represent four different times
of day that medicine may need to be taken---morning, afternoon, evening,
and night/bedtime. You will also need to find pictures to represent what
each medicine is used for (e.g. a blood pressure cuff to represent high
blood pressure). You may use the pictures in this guide, if appropriate.
It may be helpful to consult the doctor or pharmacist to determine each
medication's purpose.

The graphics used in guide are from the Clip Art library of Microsoft
Word.

**Table 1: Organize Information for the Pill Card**

+----------+---------------------+---------------------+---------------+
| **Me     | **Important         | **Incorporating     | **Possible    |
| dicine** | Information,**      | This Information    | Graphics      |
|          |                     | into a Pill Card**  | Used**        |
|          | **in Simple Terms** |                     |               |
+----------+---------------------+---------------------+---------------+
| Sim      | -   Take 1 pill at  | -   Picture of one  | -             |
| vastatin |     night           |     pill at         | Night/bedtime |
|          |                     |     night/bedtime   |               |
| 20mg     | -   For cholesterol |     (shown by moon) | ![](media/i   |
|          |                     |                     | mage1.wmf){wi |
|          |                     |                     | dth="0.609722 |
|          |                     |                     | 2222222223in" |
|          |                     |                     | heig          |
|          |                     |                     | ht="0.6347222 |
|          |                     |                     | 222222222in"} |
+----------+---------------------+---------------------+---------------+
| Fu       | -   Take 2 pills in | -   Picture of two  | -   Morning   |
| rosemide |     the morning and |     pills in the    |               |
|          |     2 pills in the  |     morning (shown  | ![](media/i   |
| 20mg     |     evening         |     by rising sun)  | mage2.wmf){wi |
|          |                     |     and two pills   | dth="0.754166 |
|          | -   For fluid       |     in the evening  | 6666666667in" |
|          |                     |     (shown by       | heigh         |
|          |                     |     setting sun)    | t="0.47708333 |
|          |                     |                     | 333333336in"} |
|          |                     |                     |               |
|          |                     |                     | -   Evening   |
|          |                     |                     |               |
|          |                     |                     | ![](media/i   |
|          |                     |                     | mage3.wmf){wi |
|          |                     |                     | dth="0.625in" |
|          |                     |                     | heig          |
|          |                     |                     | ht="0.6118055 |
|          |                     |                     | 555555556in"} |
+----------+---------------------+---------------------+---------------+
| Insulin  | -   Inject 24 units | -   Picture of      | -   Syringe   |
|          |     before          |     syringe in the  |               |
| ![       |     breakfast and   |     morning (shown  | ![](media/i   |
| ](media/ |     12 units before |     by rising sun)  | mage4.wmf){wi |
| image4.w |     dinner          |     and evening     | dth="0.585416 |
| mf){widt |                     |     (shown by       | 6666666667in" |
| h="0.554 | ```{=html}          |     setting sun).   | heig          |
| 86111111 | <!-- -->            |                     | ht="0.7611111 |
| 11111in" | ```                 | -   Picture of bag  | 111111111in"} |
| height   | -   For diabetes    |     of sugar        |               |
| ="0.7180 |     (sugar)         |                     | -   Sugar     |
| 55555555 |                     |                     |               |
| 5556in"} |                     |                     | ![](media/i   |
|          |                     |                     | mage5.wmf){wi |
|          |                     |                     | dth="0.674305 |
|          |                     |                     | 5555555556in" |
|          |                     |                     | hei           |
|          |                     |                     | ght="0.75in"} |
|          |                     |                     |               |
|          |                     |                     | -   Morning   |
|          |                     |                     |               |
|          |                     |                     | ![](media/i   |
|          |                     |                     | mage2.wmf){wi |
|          |                     |                     | dth="0.754166 |
|          |                     |                     | 6666666667in" |
|          |                     |                     | heigh         |
|          |                     |                     | t="0.47708333 |
|          |                     |                     | 333333336in"} |
|          |                     |                     |               |
|          |                     |                     | -   Evening   |
|          |                     |                     |               |
|          |                     |                     | ![](media/i   |
|          |                     |                     | mage3.wmf){wi |
|          |                     |                     | dth="0.625in" |
|          |                     |                     | heig          |
|          |                     |                     | ht="0.6118055 |
|          |                     |                     | 555555556in"} |
+----------+---------------------+---------------------+---------------+

**Creating a Personalized Pill Card**

**Step 1: Start with a Blank Pill Card**

Now that we have simplified the information and found all of our
graphics, we can start putting together the pill card. Start with the
pill card template (provided on page 9). You may copy this template and
customize it to create a personalized pill card for patients, parents,
or anyone else you know who has trouble keeping track of their
medicines. If you are able to use a word processor, this is the easiest
way to customize the pill card. However, you may also print out this
template and fill in the information and drawings by hand.

**Step 1:**

+--------+---------+-----------+--------+----------+-------+-------+
|        |         |           |        |          |       |       |
+--------+---------+-----------+--------+----------+-------+-------+
| **     | **Used  | **Instr   | **Mor  | **Aft    | *     | **Ni  |
| Name** | For**   | uctions** | ning** | ernoon** | *Even | ght** |
|        |         |           |        |          | ing** |       |
|        |         |           | ![     | ![       |       | ![](m |
|        |         |           | ](medi | ](media/ | ![    | edia/ |
|        |         |           | a/imag | image6.w | ](med | image |
|        |         |           | e2.wmf | mf){widt | ia/im | 1.wmf |
|        |         |           | ){widt | h="0.675 | age3. | ){wid |
|        |         |           | h="0.8 | 69444444 | wmf){ | th="0 |
|        |         |           | 222222 | 44445in" | width | .6097 |
|        |         |           | 222222 | height   | ="0.6 | 22222 |
|        |         |           | 222in" | ="0.6638 | 25in" | 22222 |
|        |         |           | height | 88888888 | heigh | 23in" |
|        |         |           | ="0.51 | 8889in"} | t="0. | heigh |
|        |         |           | 527777 |          | 61180 | t="0. |
|        |         |           | 777777 |          | 55555 | 63472 |
|        |         |           | 77in"} |          | 55555 | 22222 |
|        |         |           |        |          | 6in"} | 22222 |
|        |         |           |        |          |       | 2in"} |
+--------+---------+-----------+--------+----------+-------+-------+
|        |         |           |        |          |       |       |
+--------+---------+-----------+--------+----------+-------+-------+
|        |         |           |        |          |       |       |
+--------+---------+-----------+--------+----------+-------+-------+
|        |         |           |        |          |       |       |
+--------+---------+-----------+--------+----------+-------+-------+
|        |         |           |        |          |       |       |
+--------+---------+-----------+--------+----------+-------+-------+
|        |         |           |        |          |       |       |
+--------+---------+-----------+--------+----------+-------+-------+

**Step 2: Enter Patient Information**

Enter the name and other important information in the top row for the
person who will use the pill card. If you are making a card for your
mother, you might just want to put her name and her doctor's or
pharmacist's phone number. If you are making cards for several patients
in a clinic, you might want to include their name, address, phone
number, medical record number, and the name and phone number of the
clinic distributing the cards, or the doctor or pharmacist's name and
phone number. **Be certain to include the date that you created or
updated the card.**

**Step 3:** **Fill in Medicine Information**

Fill in information about each medicine. Enter the name of each medicine
and the amount of medicine in each pill (e.g., 20 mg) in the left hand
column. Each row should have one medicine. In the second column, titled
"Used For," enter the condition that the medicine is used for (e.g.,
cholesterol). It's OK to use non-medical words like "sugar," if that is
how the medicine is known. In the third column enter simple instructions
for each medicine---how much to take and when to take it. We will fill
this in on Sarah's card for her medicines, simvastatin, furosemide, and
insulin. You should include the brand name for each medicine in addition
to the generic name.

**Steps 2-3:**

+----------+---------+-----------+--------+--------+--------+--------+
| **Name:  |         |           |        |        |        |        |
| Sarah    |         |           |        |        |        |        |
| Smith    |         |           |        |        |        |        |
| Date     |         |           |        |        |        |        |
| Created: |         |           |        |        |        |        |
| 12       |         |           |        |        |        |        |
| /15/07** |         |           |        |        |        |        |
|          |         |           |        |        |        |        |
| **       |         |           |        |        |        |        |
| Pharmacy |         |           |        |        |        |        |
| phone    |         |           |        |        |        |        |
| n        |         |           |        |        |        |        |
| umber:** |         |           |        |        |        |        |
| 123-     |         |           |        |        |        |        |
| 456-7890 |         |           |        |        |        |        |
+----------+---------+-----------+--------+--------+--------+--------+
| **Name** | **Used  | **Instr   | **Mor  | *      | **Eve  | **N    |
|          | For**   | uctions** | ning** | *After | ning** | ight** |
|          |         |           |        | noon** |        |        |
|          |         |           | ![     |        | !      | ![     |
|          |         |           | ](medi | ![     | [](med | ](medi |
|          |         |           | a/imag | ](medi | ia/ima | a/imag |
|          |         |           | e2.wmf | a/imag | ge3.wm | e1.wmf |
|          |         |           | ){widt | e6.wmf | f){wid | ){widt |
|          |         |           | h="0.8 | ){widt | th="0. | h="0.6 |
|          |         |           | 222222 | h="0.6 | 625in" | 097222 |
|          |         |           | 222222 | 756944 | height | 222222 |
|          |         |           | 222in" | 444444 | ="0.61 | 223in" |
|          |         |           | height | 445in" | 180555 | height |
|          |         |           | ="0.51 | height | 555555 | ="0.63 |
|          |         |           | 527777 | ="0.66 | 56in"} | 472222 |
|          |         |           | 777777 | 388888 |        | 222222 |
|          |         |           | 77in"} | 888888 |        | 22in"} |
|          |         |           |        | 89in"} |        |        |
+----------+---------+-----------+--------+--------+--------+--------+
| Sim      | Chol    | Take 1    |        |        |        |        |
| vastatin | esterol | pill at   |        |        |        |        |
|          |         | night     |        |        |        |        |
| 20mg     |         |           |        |        |        |        |
+----------+---------+-----------+--------+--------+--------+--------+
| Fu       | Fluid   | Take 2    |        |        |        |        |
| rosemide |         | pills in  |        |        |        |        |
|          |         | the       |        |        |        |        |
| 20mg     |         | morning   |        |        |        |        |
|          |         | and 2     |        |        |        |        |
|          |         | pills in  |        |        |        |        |
|          |         | the       |        |        |        |        |
|          |         | evening   |        |        |        |        |
+----------+---------+-----------+--------+--------+--------+--------+
| Insulin  | D       | Inject 24 |        |        |        |        |
|          | iabetes | units     |        |        |        |        |
| 70/30    | (Sugar) | before    |        |        |        |        |
|          |         | breakfast |        |        |        |        |
|          | ![]     | and 12    |        |        |        |        |
|          | (media/ | units     |        |        |        |        |
|          | image5. | before    |        |        |        |        |
|          | wmf){wi | dinner    |        |        |        |        |
|          | dth="0. |           |        |        |        |        |
|          | 5625in" |           |        |        |        |        |
|          | he      |           |        |        |        |        |
|          | ight="0 |           |        |        |        |        |
|          | .623611 |           |        |        |        |        |
|          | 1111111 |           |        |        |        |        |
|          | 111in"} |           |        |        |        |        |
+----------+---------+-----------+--------+--------+--------+--------+

**Step 4:** **Add Pictures of the Medicine**

Using the pill image templates on page 10, copy and paste the correct
shape for each medicine into the "Name" and time of day columns as shown
below. Color each shape to represent the color of the pill. For example,
we used the circle shape and colored it light orange for Sarah's
simvastatin, and inserted this drawing into the "Name" and "Night"
columns for simvastatin.

Make sure the number of pills in the column corresponds to the number of
pills that should be taken at that time of day. For example, since Sarah
takes her furosemide twice a day, two pills each time, we put two
drawings of each of those pills in the "Morning" column and two in the
"Evening" column.

If you are including multiple pills with similar shape or color, you can
write in any markings on the pill to help distinguish one pill from
another.

**Step 4:**

+----------+---------+-----------+--------+--------+--------+--------+
| **Name:  |         |           |        |        |        |        |
| Sarah    |         |           |        |        |        |        |
| Smith    |         |           |        |        |        |        |
| Date     |         |           |        |        |        |        |
| Created: |         |           |        |        |        |        |
| 12       |         |           |        |        |        |        |
| /15/07** |         |           |        |        |        |        |
|          |         |           |        |        |        |        |
| **       |         |           |        |        |        |        |
| Pharmacy |         |           |        |        |        |        |
| phone    |         |           |        |        |        |        |
| n        |         |           |        |        |        |        |
| umber:** |         |           |        |        |        |        |
| 123-     |         |           |        |        |        |        |
| 456-7890 |         |           |        |        |        |        |
+----------+---------+-----------+--------+--------+--------+--------+
| **Name** | **Used  | **Instr   | **Mor  | *      | **Eve  | **N    |
|          | For**   | uctions** | ning** | *After | ning** | ight** |
|          |         |           |        | noon** |        |        |
|          |         |           | ![     |        | !      | ![     |
|          |         |           | ](medi | ![     | [](med | ](medi |
|          |         |           | a/imag | ](medi | ia/ima | a/imag |
|          |         |           | e2.wmf | a/imag | ge3.wm | e1.wmf |
|          |         |           | ){widt | e6.wmf | f){wid | ){widt |
|          |         |           | h="0.8 | ){widt | th="0. | h="0.6 |
|          |         |           | 222222 | h="0.6 | 625in" | 097222 |
|          |         |           | 222222 | 756944 | height | 222222 |
|          |         |           | 222in" | 444444 | ="0.61 | 223in" |
|          |         |           | height | 445in" | 180555 | height |
|          |         |           | ="0.51 | height | 555555 | ="0.63 |
|          |         |           | 527777 | ="0.66 | 56in"} | 472222 |
|          |         |           | 777777 | 388888 |        | 222222 |
|          |         |           | 77in"} | 888888 |        | 22in"} |
|          |         |           |        | 89in"} |        |        |
+----------+---------+-----------+--------+--------+--------+--------+
| Sim      | Chol    | Take 1    |        |        |        |        |
| vastatin | esterol | pill at   |        |        |        |        |
|          |         | night     |        |        |        |        |
| 20mg     |         |           |        |        |        |        |
+----------+---------+-----------+--------+--------+--------+--------+
| Fu       | Fluid   | Take 2    |        |        |        |        |
| rosemide |         | pills in  |        |        |        |        |
|          |         | the       |        |        |        |        |
| 20mg     |         | morning   |        |        |        |        |
|          |         | and 2     |        |        |        |        |
|          |         | pills in  |        |        |        |        |
|          |         | the       |        |        |        |        |
|          |         | evening   |        |        |        |        |
+----------+---------+-----------+--------+--------+--------+--------+
| Insulin  | D       | Inject 24 | ![     |        | ![     |        |
|          | iabetes | units     | ](medi |        | ](medi |        |
| 70/30    | (Sugar) | before    | a/imag |        | a/imag |        |
|          |         | breakfast | e4.wmf |        | e4.wmf |        |
| ![       | !       | and 12    | ){widt |        | ){widt |        |
| ](media/ | [](medi | units     | h="0.5 |        | h="0.5 |        |
| image4.w | a/image | before    | 548611 |        | 548611 |        |
| mf){widt | 5.wmf){ | dinner    | 111111 |        | 111111 |        |
| h="0.554 | width=" |           | 111in" |        | 111in" |        |
| 86111111 | 0.67430 |           | height |        | height |        |
| 11111in" | 5555555 |           | ="0.71 |        | ="0.71 |        |
| height   | 5556in" |           | 805555 |        | 805555 |        |
| ="0.7180 | he      |           | 555555 |        | 555555 |        |
| 55555555 | ight="0 |           | 56in"} |        | 56in"} |        |
| 5556in"} | .75in"} |           |        |        |        |        |
|          |         |           | 24     |        | 12     |        |
|          |         |           | units  |        | units  |        |
+----------+---------+-----------+--------+--------+--------+--------+

Now all of Sarah's medicines and instructions are on the card. This
provides an easy reference for her to remember each of her medicines,
what she takes them for, when she takes them, and how many she takes at
a time.

Because the card is intended to be very simple and include only the most
important information, it should be used in conjunction with the other
medicine information provided by a doctor or pharmacy. For example, if
Sarah wants to know the possible side effects of her simvastatin, she
will need to check the information leaflet that came with her medicine.

**Step 5: Print the Card**

Print the card on a color printer, preferably on a heavy-weight paper
that will not be easily lost or damaged.

**Using a Personalized Pill Card**

Sarah can easily see all of the important information about her
medicines on her pill card. She can:

-   Hang this card on her refrigerator or keep it with her medicines.

-   Bring the card with her the next time she visits her doctor, in case
    she wants to ask a question about one of her medicines, or if she
    has trouble keeping them straight.

-   Take the card with her if she travels somewhere, to help her keep
    track of her medicines while she's away from home.

**Pill Card Template**

+---------+----------+----------+--------+---------+--------+-------+
|         |          |          |        |         |        |       |
+---------+----------+----------+--------+---------+--------+-------+
| *       | **Used   | **Instru | **Mor  | **Afte  | **Eve  | **Ni  |
| *Name** | For**    | ctions** | ning** | rnoon** | ning** | ght** |
|         |          |          |        |         |        |       |
|         |          |          | ![     | !       | !      | ![](m |
|         |          |          | ](medi | [](medi | [](med | edia/ |
|         |          |          | a/imag | a/image | ia/ima | image |
|         |          |          | e2.wmf | 6.wmf){ | ge3.wm | 1.wmf |
|         |          |          | ){widt | width=" | f){wid | ){wid |
|         |          |          | h="0.8 | 0.67569 | th="0. | th="0 |
|         |          |          | 222222 | 4444444 | 625in" | .6097 |
|         |          |          | 222222 | 4445in" | height | 22222 |
|         |          |          | 222in" | he      | ="0.61 | 22222 |
|         |          |          | height | ight="0 | 180555 | 23in" |
|         |          |          | ="0.51 | .663888 | 555555 | heigh |
|         |          |          | 527777 | 8888888 | 56in"} | t="0. |
|         |          |          | 777777 | 889in"} |        | 63472 |
|         |          |          | 77in"} |         |        | 22222 |
|         |          |          |        |         |        | 22222 |
|         |          |          |        |         |        | 2in"} |
+---------+----------+----------+--------+---------+--------+-------+
|         |          |          |        |         |        |       |
+---------+----------+----------+--------+---------+--------+-------+
|         |          |          |        |         |        |       |
+---------+----------+----------+--------+---------+--------+-------+
|         |          |          |        |         |        |       |
+---------+----------+----------+--------+---------+--------+-------+
|         |          |          |        |         |        |       |
+---------+----------+----------+--------+---------+--------+-------+
|         |          |          |        |         |        |       |
+---------+----------+----------+--------+---------+--------+-------+

**Common Pill Shapes**

Use these shapes to represent each of the pills that you are including
on the pill card. Shapes are included for whole and half pills. You will
need to copy the shape that you need and paste it onto the pill card.
You will then need to color the shape to match the color of the actual
pill. You can do this by double-clicking on the shape to bring up the
Format AutoShape box. In the Colors and Lines tab under Fill, click on
the Color drop-down menu to choose the appropriate color. You may also
color in the shapes by hand after printing out the card.

+---------------+------------+------------+------------+------------+
| Rounded       | Round pill | Diamond    | Oval pill  | Two-tone   |
| rectangle     |            | pill       |            | capsule    |
|               |            |            |            |            |
| []{.mark}     |            |            |            |            |
+---------------+------------+------------+------------+------------+
| Half rounded  | Half round | Half       | Half oval  | Square     |
| rectangle     | pill       | diamond    | pill       | pill       |
|               |            | pill       |            |            |
| []{.mark}     |            |            |            |            |
+---------------+------------+------------+------------+------------+

**Common Images for Medication Uses**

+----------------+----------------+------------------+----------------+
| **Heart**      | **Blood        | **               | **Pain**       |
|                | Pressure**     | Diabetes/Sugar** |                |
| ![](media      |                |                  | ![](media      |
| /image7.jpeg){ | ![](medi       | ![](med          | /image9.jpeg){ |
| width="0.78333 | a/image8.wmf){ | ia/image5.wmf){w | width="0.81041 |
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| 3333333333in"} | ight="0.769444 |                  | 6666666667in"} |
|                | 4444444445in"} |                  |                |
+----------------+----------------+------------------+----------------+
| **Depression** | **Sleep**      | **Asthma/        |                |
|                |                | Breathing**      |                |
| ![](media/     | ![](media      |                  |                |
| image10.wmf){w | /image11.wmf){ | ![]              |                |
| idth="0.575in" | width="0.80347 | (media/image12.w |                |
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| 8888888889in"} | ight="0.627083 | height="0.7583   |                |
|                | 3333333333in"} | 333333333333in"} |                |
+----------------+----------------+------------------+----------------+