Flashcards in L1-2: Health Literacy Deck (47)
What is important to consider for Plain Language - Visual Clarity?
● Using headings and lists
● Use infographics and tables
● Organize your material. Break into chunks
● Use a clear and readable font. Avoid all caps
● Use left justification
● Leave white space around lists and margins
Describe: 2. Focus on Key Messages and Repeat
● Limit information (if appropriate)
- Focus on 1-3 key points
● Develop short explanations for common medical conditions and side effects
● Discuss specific behaviors rather than general
- What the patient needs to do
● Review each point at the end
Describe: 3. Use a “Teach Back” to Check Understanding
Refer to nice figure on slide 66... Clinician explains concept-clinician assesses patient recall and comprehension-> clinician clarifies and tailors explanation -> clinician reassesses patient recall and comprehension-patient recalls and comprehends -> leads to adherence
Examples of Teach Back scripts?
● I want to make sure I explained everything clearly. If
you were trying to explain to your partner how to take
this medicine, what would you say?
● Let’s review the main side effects of this new medicine. What are the 2 things that I asked you to watch out for?
● Show me how you would use this inhaler.
● Can you tell me what you will do when you get home?
Describe: 4. Effectively Solicit Questions
- “any” is associated with “none”, as in, “I don't have any bananas.”
- When patients hear “Do you have any questions?,” it may subconsciously trigger a blocking mechanism.
- Instead of perceiving an invitation to share
information, patients may perceive this phrase
as a signal that the conversation is done.
So Don’t say:
-Do you have any questions?
- Any questions?
-What questions do you have?
Describe: 5. Patient-Friendly Materials
● Appropriate Content
● Plain Language
There is inconsistent laeblling, drug sheets are not always included, warnings not the same
what is the relation with healthy literacy and diabetes and medication management?
Level 3 is adequate health literacy
Diabetes goes down by 50% from level 2 to level 3
Low literacy leads to less knowledge and decrease in good medication management
Effect on adherence is varied
94% of those with adequate health literacy knew the symptoms of hypoglycemia compared with only 50% of inadequate health literacy
how can health literacy lead to decreased Knowledge and Understanding
- Pt with limited health literacy have less knowledge about their disease and how to manage it
- persons with limited health literacy did not know about factors that could lower blood pressure such as weight loss and exercise
- Decreased understanding of appropriate medication use
- Misunderstanding label instructions
- Warning labels may not be useful for patients with limited health literacy
how can health literacy lead to decreased Ability for Medication Management
- the correct identification of medications, opening the appropriate containers, proper selection of the correct dose, and timing of administration,54 as well as appropriate use of containers such as MDIs, nasal sprays, and eye drops
- only 40.5% of patients with inadequate health literacy were able to name any of their antihypertensive medications, compared to 68.3% of those with adequate health literacy
- Improper MDI technique
how can health lit affect adherence?
- Uncertain effect, conflicting
- Some showed pt less likely to be adherent to their medications
- Some studies concluded that health literacy is not independently associated with adherence
- Some found increase in adherence
how can health lit increase healthcare costs?
- Patients with limited health literacy tend to seek medical care when they are sicker, leading to higher use of emergent care and longer hospitalizations
- caring for persons with limited health literacy is associated with higher healthcare costs
what are shortcomings to leaflets?
- Numerous studies indicate that most health information handouts are written at a level far beyond that which an average adult can understand
- The average American adult reads at about the eighth grade level and most handouts exceed these levels
- Patients with lower literacy were less likely to have looked at the medication guides (16.7% vs 32.9%)
what are shortcomings to med labels?
- Font too small
- Color and boldface were used to highlight items most useful to the pharmacist as opposed to highlighting -the information that is most useful to the consumer
- Variable warning instructions
what are shortcomings to counseling?
- Patients with limited health literacy are significantly less likely to ask questions of their providers
- physicians only communicate about three of the five expected elements of drug information (name of medication, purpose, dose and timing, duration, and adverse effects)
-drug mixups which can be dangerous
what are common signs for limited health liteacy (informal assessments)
1. Reads slowly
2. Has difficulty telling a coherent story
3. Fills out forms incorrectly/incompletely
4. Uses excuses such as I forgot my glasses, read this later, don’t have time to read this now
5. Brings along a friend or family member for assistance
6. Fails to show up for appointments or is late for refills
7. Doesn’t ask questions for clarification
8. Has difficulty following instructions
9. Nods in agreement or expresses understanding but doesn’t truly understand information
during med review
Do not know contents of what they are taking
Old bottles with personal markings
what formal assessments can be used?
- Screen patients then tailor accordingly or use universal precautions
- The REALM is a word-recognition test and estimates health literacy based on patients’ ability to pronounce a list of medical terms. The TOFHLA consists of a reading comprehension section to measure prose literacy and a numeracy section.
- The Newest Vital Sign (NVS) assesses health literacy by having patients review a nutrition label and answer six questions about the label.