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When patients and healthcare professionals are talking about a medical issue — big or small — both want to know that they have been fully understood. This is not always easy but improved health literacy, for both patients and healthcare professionals, can help.
For people working in the healthcare sector, health literacy is about communicating clearly and taking account of a person’s possible health literacy and numeracy needs. For patients, health literacy is the ability to understand and act on health information. It is also about empowering patients to ask questions, exploring their options and making informed decisions about their health.
Worryingly, a recent EU Health Literacy Survey showed that four-in-10 Irish adults had limited health literacy. This means that when dealing with health services, many adults find it challenging to fully understand health information and their health condition and treatment. They might also have difficulties working out and following instructions on medicine labels.
This is part of a wider literacy problem, as an OECD research study showed that one-in-six Irish adults find reading and understanding everyday texts difficult. For example, this could include bus timetables or restaurant menus. One-in-four Irish adults struggle with everyday maths, such as basic addition and subtraction.
However, even many patients who deal effectively with other aspects of their lives can find health information difficult to obtain, understand, or use. In fact, research shows that one-in-five Irish people are not fully confident that they understand the information they receive from their healthcare professional. In a survey conducted in 2015, 17 per cent of respondents said they had taken the wrong amount of medication on at least one occasion.
New research by the Healthy and Positive Ageing Initiative (HaPAI) also shows that a better understanding of health literacy by nurses and doctors could improve the health and wellbeing of people aged over 50. The findings show that:
24 per cent of older people said that their doctor or nurse rarely or never explains the results of medical exams.
26 per cent said that their doctor or nurse rarely or never explains different treatment options.
29 per cent felt discouraged to talk about emotional, nervous or psychiatric problems, such as stress, sadness or anxiety.
42 per cent felt discouraged from talking about sensitive problems, such as their sex life or incontinence.
The HaPAI outlines several steps that healthcare professionals can take to ensure older people feel more comfortable. These include explaining results and listening to opinions, and also supporting patients with cognitive issues and little or no education.
So, the benefits of improving health literacy for all concerned are clear. Patients who are better informed about their health have:
More effective consultations with their healthcare provider.
Are better informed about the medicines they are prescribed.
Are more likely to comply with their medication and as a result, have improved health outcomes.
People with improved health literacy skills are also more likely to make use of health screening programmes, tend to present at much earlier stages of disease and are less likely to be hospitalised.
Research has shown that health literacy interventions can significantly impact healthcare costs, outcomes and health disparities. Healthcare professionals have a real responsibility to engage in health literacy. However, they must be equipped with the awareness and tools to improve patient understanding. In practical terms, we need to undertake awareness-raising and training activities with healthcare workers at all levels, beginning in their undergraduate courses.
Health literacy also needs to be integrated into all national health campaigns and screening projects. Thankfully, many health services, including general practices, pharmacies and hospitals, are now looking at how they engage with their patients, particularly those with limited health literacy. By being aware and making it easier for all patients to use their services, they are becoming health literacy-friendly and delivering a better service.
A GP that is health literacy-friendly will look out for signs that a patient may not understand the instructions they just gave them. They might then use a ‘teach-back’ approach, where they ask the patient to repeat in their own words what they understand they have to do now. If the patient hasn’t fully understood the instructions, then this approach enables the GP to repeat them, perhaps using different terms and examples to explain what they mean.
Pharmacies also play a critical role in helping people understand their health issues and the steps they can take to improve their health. To help them achieve this, pharmacies can take part, along with general practices, in the Crystal Clear Programme. This national programme offers pharmacies and general practices the opportunity to gain a unique health literacy quality mark. It has been developed by the Irish Pharmacy Union (IPU), Merck Sharp & Dohme (MSD) and NALA. This Crystal Clear Mark recognises pharmacies and general practices that deliver a health literacy-friendly service to their customers. This means the service takes account of and supports the literacy and numeracy needs of its customers and regularly evaluates and improves its health literacy practices.