scholarly journals The impact of textual elements on the comprehensibility of drug label instructions (DLIs): A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250238
Author(s):  
Ekram Maghroudi ◽  
Charlotte Miriam Joyce van Hooijdonk ◽  
Heidi van de Bruinhorst ◽  
Liset van Dijk ◽  
Jany Rademakers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Literacy ◽  
Significant Proportion ◽  
Literacy Skills ◽  
Correct Interpretation ◽  
Plain Language ◽  
Drug Label ◽  
Limited Health Literacy ◽  
The Impact ◽  
Medical Jargon

Introduction Correct interpretation of drug labels instructions (DLIs) is needed for safe use and better adherence to prescribed drugs. DLIs are often too difficult for patients, especially for those with limited health literacy. What is yet unknown, is how specific textual elements in DLIs (e.g., the presentation of numbers, or use of medical jargon) and patients’ health literacy skills are related to the comprehension of DLIs. In order to provide concrete directions for health professionals on how to optimize drug prescriptions, we performed a systematic review to summarize the available research findings on which textual elements facilitate or hinder the correct interpretation of DLIs in relation to patients’ health literacy. Method A systematic search was performed in PubMed, EMBASE, PsychINFO, and Smartcat (until April 2019) to identify studies investigating textual elements that facilitate or hinder the correct interpretation of DLIs in relation to patients’ health literacy. Results A total of 434 studies were identified of which 28 studies met our inclusion criteria. We found that textual elements contributing to the correct interpretation of DLIs were: using explicit time periods in dosage instructions, using plain language, presenting numbers in a numerical format, and providing DLIs in patients’ native language. Multistep instructions per instruction line, using abbreviations and medical jargon seem to hinder the correct interpretation of DLIs. Although health literacy was taken into account in a majority of the studies, none of them assessed the effectiveness of specific textual elements on patients’ comprehensibility of DLIs. Conclusion Based on our findings, we provide an overview of textual elements that contribute to the correct interpretation of DLIs. Optimizing the textual instruction on drug labels may increase the safety and adherence to prescribed drugs, taking into account that a significant proportion of patients has low health literacy.

scholarly journals Health literacy level in a various nephrology population from Québec: predialysis clinic, in-centre hemodialysis and home dialysis; a transversal monocentric observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Annabel Boyer ◽  
Yannick Begin ◽  
Julie Dupont ◽  
Mathieu Rousseau-Gagnon ◽  
Nicolas Fernandez ◽  
...  
Keyword(s):  
Health Literacy ◽  
Observational Study ◽  
Health Information ◽  
Healthcare Providers ◽  
Significant Proportion ◽  
Good Health ◽  
Sufficient Information ◽  
Home Dialysis ◽  
Limited Health Literacy ◽  
Limited Health

Abstract Background Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD). Methods This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups. Results Patients on PD had a significantly higher BHLS’score than patients on ICHD (p = 0.04). HLQ’s scores differed across the groups: patients on HHD (p = 0.01) and PD (p = 0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p = 0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p < 0.001). Conclusion In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.

scholarly journals Prevalence of limited health literacy among patients with type 2 diabetes mellitus: A systematic review

PLoS ONE ◽  
2019 ◽  
Vol 14 (5) ◽  
pp. e0216402 ◽  
Author(s):  
Adina Abdullah ◽  
Su May Liew ◽  
Hani Salim ◽  
Chirk Jenn Ng ◽  
Karuthan Chinna
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Literacy ◽  
Limited Health Literacy ◽  
Limited Health

Cost-health literacy training in fellowship: A QI initiative.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 80-80
Author(s):  
Katrina Fischer ◽  
Sidharth Anand ◽  
Anne M. Walling ◽  
Sarah Marie Larson ◽  
John Glaspy
Keyword(s):  
Health Literacy ◽  
Los Angeles ◽  
Literacy Skills ◽  
Direct Patient Care ◽  
Financial Toxicity ◽  
Subjective Distress ◽  
Communication Practices ◽  
The Cost ◽  
The Impact ◽  
Case Based

80 Background: Limited cost-health literacy is a significant factor in the physicians ability to discuss and navigate patient financial concerns. Because these skills are not formally taught during training, the cost-health literacy of graduate medical trainees is unknown. This study describes a QI initiative to measure and improve upon the cost-health literacy skills of oncology fellows as it pertains to objective knowledge and self-perceived cost communication practices. Methods: All oncology fellows (n = 19) at the University of California, Los Angeles were invited to participate in QI project during the fall of 2019. Fellows participated in a case-based curriculum over three months, consisting of a group didactic on financial toxicity (45 minutes) and an interactive case based learning scenario that highlighted financial toxicity risk factors and areas for intervention (30 minutes). We concluded with a group discussion (30 minutes) to review and consolidate strategies, identfying internal and external resources that enable physicians to navigate financial toxicity in direct patient care. A cost-health literacy survey was administered at baseline and at the conclusion of the curriculum to evaluate the impact of the program. Results: Of 19 participants, 17 participated and 16 completed both the pre and post survey. These 16 were included in the analysis. After the intervention, participants were more likely to report comfort discussing out of pocket costs (50% v 19%, p = 0.005) and to feel they could help a patient experiencing financial toxicity (62% v 6%, p = 0.005). Fellows were more likely to report awareness of resources that were available to them to help patients manage financial toxicity (69% v 19%, p 0.003) but were no more likely to report asking patients about their subjective distress due to treatment related costs (57% v 50%, p = 0.759). Conclusions: We can teach and improve upon cost-health literacy skills through participation in a targeted, brief curriculum. Further studies are warranted to determine how this approach can be applied in other settings and how it objectively impacts cost communication practices.

scholarly journals The Impact of Limited Cancer Health Literacy on Patient Preference for Shared Care

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 106s-106s ◽  
Author(s):  
C.M.H. Chan ◽  
N.A. Taib ◽  
L.H. Wee ◽  
D. Blanch-Hartigan ◽  
E. Krupat ◽  
...  
Keyword(s):  
Health Literacy ◽  
Cancer Patients ◽  
Patient Preference ◽  
Shared Care ◽  
Cancer Outcomes ◽  
Limited Health Literacy ◽  
Patients With Cancer ◽  
Cancer Literacy ◽  
Limited Health ◽  
The Impact

Background: Patient are increasingly expected to engage in their own care. However, patients with limited health literacy often struggle with this. The expectation of patients' engagement in health care decisions by their healthcare providers likely increases the burden that cancer patients are already experiencing following a life-changing diagnosis. Involving patients with cancer in medical decision-making requires them to have an adequate understanding their disease and treatment options. Limited health literacy poses a barrier to patient engagement in their own care, contributing to health disparities and poorer cancer outcomes. Aim: Our primary objective was to determine levels of health literacy among patients with cancer and the extent of its association with patient preference for care. We also sought to identify sociodemographic and clinical characteristics associated with limited cancer health literacy. Methods: As part of a larger prospective cohort study, N = 345 adult cancer patients attending a large, university-affiliated outpatient oncology clinic were recruited using consecutive sampling. Face to face interviews were conducted using questionnaires. Instruments used included the 30-item Cancer Health Literacy Test (CHLT-30), and the Patient-Practitioner Orientation Scale (PPOS) to determine patient preference for shared care. The relationship between cancer health literacy and patient preference for shared care was examined using bivariate analysis, with logistic regression used to identify predictors. Results: Mean patient age was 60.0 ± 11.6 years. A greater female preponderance was observed (69.4%), with over half of patients indicating secondary school completion (51.6%). Up to 79.3% of patients reported a monthly household income of less than RM 4000 (approximately USD 1000), placing them in the bottom 40% of household incomes in Malaysia. A total of 59.1% of patients (n = 204) in this sample were found to have limited cancer health literacy, with an average score of 14.40 ± 4.04 out of a full score of 30. Patients with limited cancer literacy were 1.69 times (95% CI 1.42-2.03) less likely to prefer active participation in their care. Conclusion: Rates of limited cancer literacy in this sample (59.1%) appear to be at least three times higher than prevailing rates in high resource countries with established cancer control programs such as the United States (18%). One out of every two patients with cancer in this study were found to possess limited health literacy, making this a significant issue particularly given its association with lesser patient preference for shared care. This study marks an important first step toward increasing health literacy among patients with cancer and empowering patients to participate in their care, which may help mitigate the impact of disparities such as lower educational and socioeconomic levels traditionally associated with poorer cancer outcomes.

scholarly journals Development of a plain-language guide for discussing breast cancer genetic counseling and testing with patients with limited health literacy

2020 ◽  
Author(s):  
J. A. M van der Giessen ◽  
M. G. E. M. Ausems ◽  
E. van Riel ◽  
A. de Jong ◽  
M. P. Fransen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Genetic Counseling ◽  
Health Literacy ◽  
Healthcare Professionals ◽  
Cancer Genetic Counseling ◽  
Plain Language ◽  
Cancer Genetic ◽  
Limited Health Literacy ◽  
Counseling And Testing ◽  
Limited Health

Abstract Purpose Due to limited health literacy and resulting ineffective communication between healthcare professionals and patients, not all eligible patients are offered breast cancer genetic counseling and testing. We aimed to develop a plain-language guide to increase effective communication about genetic counseling and testing with breast cancer patients with limited health literacy. Methods Together with oncological healthcare professionals, we drafted a list of jargon words frequently used during (breast) cancer genetic counseling. In a focus group interview with breast cancer counselees with limited health literacy, who had received genetic counseling before, we reformulated these words in plain language. Low-literate individuals, who are not familiar with breast cancer care or genetic counseling, reflected on the draft of the guide. Completeness, acceptability, and perceived usability were tested in an online questionnaire among healthcare professionals. Results The result is a plain-language guide for genetic counseling and testing with 33 frequently used jargon words and a reformulation of these words in plain language. Acceptability and perceived usefulness of the guide among healthcare professionals (n = 58) were high. Conclusion The plain-language guide provides opportunities to facilitate communication about genetic counseling and testing with patients with limited health literacy and could enhance opportunities for patients to make informed decisions to participate in genetic testing. As the intention from healthcare professionals to use the plain-language guide is high, implementation of the guide in a real-life setting seems promising.

Plain Language Pediatrics

2008 ◽  
Author(s):  
Mary Ann Abrams ◽  
Benard P. Dreyer
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Patient Education ◽  
Health Care Providers ◽  
Care Providers ◽  
Plain Language ◽  
Reading Levels ◽  
Limited Health Literacy ◽  
Ear Infections ◽  
Limited Health

An essential tool to help improve communication between pediatrician and patient or family, Plain Language Pediatrics offers a framework for implementing a plain language approach to communication in your office, and provides specific steps you can take to ensure the information you present to patients and their parents is clearly understood. Included are 25 reproducible plain language patient education handouts--in English and Spanish! Plain Language Pediatrics combines health literacy and plain language principles to present information in a way that makes it as easy as possible for everyone to understand, and applies these principles to a variety of ambulatory acute, chronic, and preventive conditions. Common pediatric topics such as asthma, ADHD, ear infections, and medical dosing are addressed in detail. This robust resource is divided into 2 parts. Part I explores limited health literacy, including the scope of the problem, how it affects children in particular, and how health care providers can address and overcome health literacy issues with patients and their caregivers. At the heart of Part II is a new series of 25 reproducible patient education handouts in English and Spanish that feature need-to-know information up front, health care terms and jargon, practical pronunciation guides, low reading levels, user-friendly layouts, and simple, purposeful illustrations.

scholarly journals A Systematic Review of the Prevalence and Associations of Limited Health Literacy in CKD

2017 ◽  
Vol 12 (7) ◽  
pp. 1070-1084 ◽  
Author(s):  
Dominic M. Taylor ◽  
Simon D.S. Fraser ◽  
J. Andrew Bradley ◽  
Clare Bradley ◽  
Heather Draper ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Literacy ◽  
Limited Health Literacy ◽  
Limited Health

Systematic Review of Health Literacy in Childhood Cancer Patients, Survivors, and Their Caregivers

2020 ◽  
Vol 45 (4) ◽  
pp. 373-385
Author(s):  
Courtney Lynn ◽  
Lauren Quast ◽  
Hannah Rogers ◽  
Karen Effinger ◽  
Jordan Gilleland-Marchak
Keyword(s):  
Systematic Review ◽  
Health Literacy ◽  
Health Outcomes ◽  
Childhood Cancer ◽  
Cancer Patients ◽  
Cochrane Library ◽  
Adequate Health Literacy ◽  
Pediatric Cancer Patients ◽  
Demographic Correlates ◽  
The Impact

Abstract Objective This systematic review examined the literature regarding health literacy among pediatric cancer patients, survivors, and their caregivers. Specific aims were to identify and summarize measures used, levels of and demographic correlates of health literacy, effects of health literacy interventions, and associations between health literacy and health outcomes. Methods The search strategy was executed in the following databases: PubMed, EMBASE, PsycINFO, CINAHL, ERIC, and the Cochrane Library. Of the 842 unique studies retrieved, 9 met the inclusion criteria and were included in the systematic review. Results Studies used a variety of validated and study-specific measures with no measure emerging as the standard. Levels of health literacy were typically assessed subjectively and across studies the majority of those sampled self-reported adequate health literacy. Few studies examined demographic correlates of health literacy, precluding the identification of consistent predictors. Health literacy intervention research for this population is in its infancy and only pilot projects were identified; effects could not be evaluated. No studies assessed the impact of health literacy on health outcomes. Conclusions Very few studies assessed health literacy in pediatric oncology. As treatment for childhood cancer becomes increasingly complex, and patients and caregivers are expected to have adequate understanding of health information, health literacy is a critical construct that should not be overlooked.

Health literacy education: the impact of synchronous instruction

2016 ◽  
Vol 44 (2) ◽  
pp. 100-121 ◽  
Author(s):  
Tricia Lantzy
Keyword(s):  
Health Literacy ◽  
Literacy Instruction ◽  
Literacy Education ◽  
Literacy Skills ◽  
Content Type ◽  
Face To Face ◽  
Confidence Levels ◽  
Face To Face Instruction ◽  
The Impact ◽  
Synchronous Online

Purpose This paper aims to examine the integration of librarian-led health literacy instruction into an undergraduate course, focusing specifically on how the method of instruction impacts learning outcomes and self-reported confidence levels in completing a course assignment. Undergraduate students struggle to critically evaluate online health information in an increasingly diffuse information landscape. Assessing the success of different instructional techniques aimed at building these abilities can guide pedagogical choices and provide new opportunities to increase health literacy skills in a variety of library user populations. Design/methodology/approach A quasi-experimental research design with pre- and post-tests and a participant survey was used to compare one-shot information literacy instruction techniques in two hybrid sections of a kinesiology course. One class received a traditional, face-to-face librarian-led session and the other a synchronous online instructional session through web conferencing. Findings There were no significant differences in student learning between the in-person and online groups. Students in both conditions demonstrated an extremely significant increase from pre-test to post-test scores, suggesting that librarian-led instruction in either format can lead to substantial learning of online health literacy skills. Survey results showed no significant differences in confidence levels following instruction and suggest that both methods of instruction provide a positive learning experience for students. Originality/value This study provides evidence that synchronous online instruction can be as effective as face-to-face instruction in teaching students to evaluate health-related information resources. These findings are valuable for librarians in a variety of settings who are considering providing health literacy education in an online environment.

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