Are You (Health) Literate?

13 02 2013

plainenglishHow’s your health literacy? Literacy, in this instance, doesn’t only mean can you read and write—are you literate. It means can you read instructions on a bottle of medicine, can you listen to a healthcare professional tell you about your health problem and walk away fully understanding what she said, and can you then figure out how to get the care you need for that particular problem?

The IOM defines health literacy as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

Po-tay-to, po-tah-to.

By any definition, I suspect that most of us fall short of acing the health literacy quiz.

I went in to see my dermatologist last week. Every year I go to her office, she looks at my rosacea, and renews my prescriptions.

And every year I learn something new about my meds.

I’m not sure if she’s not offering all the information or if I’m not retaining it.

This year, I learned that I have to take Oracea® at the same time every day because it lasts 24 hours. If I take it at 6:00 p.m. one day and 7:00 a.m. the next day, that’s too often, and if I take it at 7:00 a.m. one day and 6:00 p.m. the next day, that’s not often enough.

I could swear that she did not tell me this basic piece of information at any time in the past. (I’ve been taking this pill for three years.) She could swear that I’m not paying attention and that she did tell me at some point.

I looked at the bottle when I got home and directions were to take one capsule by mouth one time daily (didn’t mention the same time of day thing).

I don’t know. It’s hard to say where the communication fell down. The point is, it did.

So what can we as patients do about our health literacy?

There’s a lot of info on the web for clinicians and others on how to communicate with those who have low health literacy. In other words, putting the onus of improvement on the provider.

That’s good. Many providers don’t talk the talk of the non-scientist. But what can we do to keep up our end of the relationship?

It’s harder than you’d think. Because we’re not medically trained, we don’t always know to ask certain questions. We rely on the provider to tell us what we need to know (and then some).

One provider I saw recently wanted to prescribe a medicine that I’ve not used before. What are the side effects, I wanted to know.

He snorted impatiently and pulled out his smartphone and showed me a list and said he didn’t have time to go through them all, but if I wanted to sit there and read them I could.

Hmmmm.

On the other side of that coin, I don’t write down everything a provider tells me about a new medicine. I trust to memory and the directions on the bottle. Not always the way to go, apparently.

Here’s a starting place, if you want to create a checklist for yourself: http://www.ahrq.gov/questions/ 

Share any other ideas you have in the comments. Maybe we can chip away at this wall from our side while the providers do the same on their side.

One day, the wall will be gone.

By Trish Parnell





Improving Health Literacy

21 06 2010

Nearly 9 out of 10 adults have problems understanding and using basic health information.

Insufficient health literacy (a person’s ability to understand health information) is not limited to a select group.  It cuts across all cultures, levels of education and income, and all age groups.

We need to be educated to improve our health literacy, so that we can make optimal health-related choices.

Toward this end, the Department of Health and Human Services, led by Howard K. Koh, M.D., M.P.H., Assistant Secretary for Health, has developed the National Action Plan to Improve Health Literacy.

The plan does a good job of outlining the barriers to health literacy, identifying goals, and providing some steps to reach those goals:

  • Develop and disseminate health and safety information that is accurate, accessible, and actionable
  • Promote changes in the health care system that improve health information, communication, informed decisionmaking, and access to health services
  • Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in childcare and education through the university level
  • Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community
  • Build partnerships, develop guidance, and change policies
  • Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy
  • Increase the dissemination and use of evidence-based health literacy practices and interventions

The American Medical Association (AMA) Foundation has done a lot of work over the years toward improving health literacy, providing helpful tips and tools to physicians to improve communication and understanding between patients and providers.

In fact, lots of groups are working on health literacy.  If you search the term on the Internet, you’ll get half a million results or more.

If so many people are working on it, why is it still a problem?

It’s a tough nut to crack. Low literacy is a key factor in non-compliance with healthcare recommendations. For example, if the directions for taking medication are complicated, or the instructions for recovery from surgery are hard to understand, chances are patients will be reluctant to ask for help in deciphering the language and therefore they will not be able to follow the directions. In other words, they become non-compliant.

Unfortunately, many healthcare professionals don’t always know why a patient is not responding to treatment.  They may not know that there’s a non-compliance issue and that it’s connected to low health literacy.

Low health literacy plays a significant role in:

For the health of our population, we as educators need to become better at finding ways to improve health literacy. Perhaps Dr. Koh’s plan will blaze some trails.

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