Healthcare providers must take four immediate steps to improve their patients' health literacy and make sure patients understand the health information and instructions they receive, according to a new article in the American Family Physician.
National data indicates that more than one-third of adults in the U.S., or more than 80 million people, have limited health literacy--skills such as reading, writing, numeracy, communication and, increasingly, the use of electronic technology, according to the article. And most patients neglect to tell clinicians that they don't understand the information or may have trouble remembering what they have been told.
A lack of health literacy may mean that patients don't understand the wording on medication bottles, food labels, appointment slips, discharge instructions, informed consent documents, medical forms, insurance applications, medical bills, and health education materials.
Lead author Lauren Hersh, M.D., from the Thomas Jefferson University in Philadelphia, and her team, recommend steps that organizations can take:
- Use universal health literacy precautions to provide understandable and accessible information to all patients, regardless of their literacy or education levels, such as avoiding medical jargon and breaking down information into small concrete steps
- Prioritize and limit information to three key points or tasks for each patient visit
- Use the teach-back method where the patient explains the new information in his or her own words to assess whether a patient comprehends information
- Simplify forms and offer assistance completing them
Although U.S. adults on average read at an eighth-grade level, more than 75 percent of patient education materials are written at a high school or college reading level. Instead organizations must write printed information at or below a fifth- to sixth-grade reading level and use visual aids, graphs, and pictures to enhance patient understanding.
In an accompanying opinion piece, Barry D. Weiss, M.D., associate medical editor for the publication, recalled the mother of a child with strep throat who seemed smart, enthusiastic, and involved in her child's care and how stunned he was when she told him she could not read and had not understood much of what he had told her. He said physicians need to implement practice-wide changes and individual communication changes to be sure patients understand health information.
Limited health literacy can result in medication errors, failure to follow through on tests, less use of preventive care and increased hospitalization rates, the study authors said. That is in line with serious consequences found in other studies, including one that showed low health literacy was linked to increased risk of death for patients hospitalized for acute heart failure after discharge. It's also a problem for people purchasing health insurance where consumers face confusing terms and a lack of answers to some basic questions, such as whether their doctor will take their insurance plan.