A randomly selected sample of all German package leaflets investigated in 2005 was reanalyzed in 2015 for different important and predefined typographic subjects.

The 138 package leaflets revisited in 2015 showed significant increases in word count (average 2551 words), font size (1.43 mm x-height, 2.0 mm cap-height), line spacing (3.13 mm), use of text attributes (for example, lists in 94.2% and bold print in 83.2% package leaflet’s body text), use of light-condensed or condensed font (34.1%), and use of portrait format (81.9%) (p ≤0.015). Otherwise, line length significantly decreased to on average 62.6 characters per line (p = 0.012) and the classes of fonts used remained almost unchanged.

To achieve any further increase of package leaflet font size and other typographic improvements, a significant decrease in text volume is essential. To this end, replacing the current 840-word QRD template with a compressed 200-word version would allow optimisation of typography in all package leaflets, without deleting information essential for patients or incurring any unfavourable format increase. (Therapeutic Innovation & Regulatory Science)