Not Simply More Text, but Better Orientation

Finding suitable participants for clinical trials is a key challenge for sponsors. At the same time, different barriers can make it more difficult for people to access a trial. Inclusive trial designs therefore also consider the needs and circumstances of potential participants. One such barrier can be access to written information. Dyslexia, for example, can make it more difficult to read and process written words.

On the few square centimeters available on a syringe or vial, regulatory requirements, variable study data, and, in international trials, multiple languages all compete for space. All this information has to be organized within the available area. Small font sizes and a high density of information are therefore not uncommon.

What is efficient from a space perspective, however, can become a barrier for trial participants with dyslexia. In its Dyslexia Style Guide, the British Dyslexia Association recommends, among other things, clearly structured content, sufficient white space, short sections of text, and regular headings to make information more accessible to people with dyslexia. Images and pictograms can also help people locate and understand information within a text.¹

Rethinking Labeling

“Accessibility requires us to look at labeling from a different perspective,” says Frank Jäger, Commercial Director CCL Clinical worldwide. “We should not only ask how the required information can fit on the container. We also need to consider how we can make that information easier for trial participants to access.”

The sponsor and the relevant specialist departments determine which medical and regulatory information must be communicated. Label manufacturers then translate this content into a physical and, increasingly, digital format. “We are not medical writers,” Jäger emphasizes. “But we can provide our customers with very specific guidance: How much space is available? How can the content be organized effectively on the respective container? What technical options do we have to make information easier to find and access?”

More Space for Design

A single-layer label is not the only way to provide information on a syringe, vial, or bottle. Multi-layer labels, booklet labels, and wrap-around solutions can significantly expand the available space for information. However, this additional space only improves accessibility if it is not simply filled with even more densely packed text.

For Frank Jäger, the additional area primarily creates greater flexibility in design. “We can use larger font sizes and more spacing, separate information more clearly, and highlight important content. Headings, colors, or pictograms can also help users navigate the label more easily.” Many of these approaches are also included in the Dyslexia Style Guide.²

Making Information Easier to Find

For an extensive booklet label, index or tab solutions can make navigation easier. They provide direct access to defined sections of a label and create a visual hierarchy. For Jäger, this illustrates an important distinction between providing more information and making information more accessible: “The goal is not to produce as many pages as possible. The additional space has to provide a benefit for the user. If relevant information can be found more easily, the label performs its function better.” For people with dyslexia in particular, this type of structure can help them locate relevant information without first having to search through large amounts of text.

Pictograms and other visual elements can also support textual information. Studies on medication information have shown positive effects on comprehension in certain applications. However, these findings cannot simply be generalized to every pictogram or every target group. Among the key factors are whether the symbols used are understandable and have been validated. Pictograms should therefore be used to complement rather than replace text.³

“Our label designers use pictograms only when they support and structure information. They do not replace medical statements,” explains Frank Jäger. “The same applies to color. It can be used to distinguish information areas and make recurring elements recognizable. Ultimately, our expertise lies in taking the content provided to us and developing a label that works technically while also being as easy to use as possible.”

Creating Additional Ways to Access Information

QR codes or NFC technology can connect printed labels with digital content. This makes it possible to continue providing information in printed form while adding another way to access it, such as an audio version or video. “What content is provided there and which regulatory requirements apply remains the sponsor’s responsibility. The label provides technical means of access. This multimodal approach can be particularly relevant for people with dyslexia,” says Jäger.

Many of these measures are not helpful exclusively for people with dyslexia. A clear structure and different ways of presenting information can also make it easier for other trial participants to navigate the information provided. As Frank Jäger summarizes: “Our labels do not simply create more space for text, but more space for orientation.”

References

1. British Dyslexia Association (2023): Dyslexia Style Guide 2023. British Dyslexia Association.
   https://cdn.bdadyslexia.org.uk/uploads/documents/Advice/style-guide/BDA-Style-Guide-2023.pdf (accessed August 14, 2026).
2. British Dyslexia Association (2023): Dyslexia Style Guide 2023. British Dyslexia Association.
   https://cdn.bdadyslexia.org.uk/uploads/documents/Advice/style-guide/BDA-Style-Guide-2023.pdf (accessed August 14, 2026).
3. Ferreira-Alfaya, F. J.; Zarzuelo-Romero, M. J.; Cura, Y. (2024): “Pharmaceutical pictograms to improve textual comprehension: A systematic review.” Research in Social and Administrative Pharmacy, 20(2), 75–85. https://doi.org/10.1016/j.sapharm.2023.11.007.

CCL Clinical

The CCL Clinical Business Unit is the global specialist of CCL Industries Inc. for products and services in the clinical trials sector. With locations in the USA, Canada, Europe, and Asia, it brings together decades of experience and expertise from hundreds of professionals. This international presence, combined with a strong foundation in local markets, enables CCL Clinical to offer flexible capacity at the highest quality standards.

The product range includes booklet labels, package inserts, folding cartons, and innovative labeling solutions with RFID and E-paper technology – all tailored to meet the needs of the research-based pharmaceutical industry. In addition, customers benefit from a wide range of services, including modeling, phrase libraries, label design, routing, randomization, and variable data printing, which support the entire lifecycle of clinical trials.