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Wednesday, December 19, 2007 5:00 PM
Newscast: Lead Story - Health Literacy

(opening music)

Rand: This is Healthcare 411 for the week of December 19, 2007

Debra: Healthcare 411 is produced by AHRQ, the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services. I’m Debra James.

Rand: And I’m Rand Gardner .

Debra: Coming up:

Rand: In today’s News and Numbers, a new AHRQ survey finds less than half of U.S. children visited a dentist at least once in 2004.

Debra: Dr. Clancy talks about health literacy and understanding health information in this week’s segment of Navigating the Health Care System.

Rand: And we feature a unique set of tools that are designed to help pharmacists communicate better with patients who have limited health literacy.

Debra: More after this message from AHRQ.


[Begin PSA: Tips to Prevent Medical Errors]

Man: Okay, here’s your ham on rye, extra mayo.

Woman: Uh, I ordered the turkey on whole wheat with mustard!

Narrator: Messing up your sandwich order is one thing, but messing up your medical care is another. Medical errors are one of the nation’s leading causes of death and injury. But you can help avoid errors by being more involved in your health care. Get the fact sheet, 20 Tips to Prevent Medical Errors, by visiting www.ahrq.gov/consumer. A message from the U.S. Agency for Healthcare Research and Quality.

[End PSA]


Debra: Now the numbers.


Debra: Fewer than half of all American adolescents - only 45 percent - visit a dentist each year, according to the latest AHRQ data. The data, which came from a 2004 survey, shows that blacks, Hispanics and children from poorer families are even less likely to get dental check ups. Only about 34 percent of black children and 33 percent of Hispanic children saw a dentist annually. And only 31 percent of kids from poor families visited their dentist even once a year. The American Academy of Pediatric Dentistry recommends at least two checkups a year in most cases and says children should begin seeing a dentist by their first birthday. These data are from AHRQ’s Medical Expenditure Panel Survey.

Rand: Nearly half of all American adults have difficulty understanding and using health information. In today’s segment on Navigating the Health Care System, we take a closer look at health literacy. With us is AHRQ Director Dr. Carolyn Clancy, thanks for being here.

Dr. Clancy: My pleasure.

Rand: Can you first start out by explaining health literacy.

Dr. Clancy: Health literacy is how well people understand and can evaluate information about their health and about health care options to make good decisions. It’s very important to understand that health literacy is not just the ability to read. People need to be able to describe their symptoms accurately and to describe their health concerns. In many ways, good communication is an essential part of health literacy.

Rand: Are there any particular segments of our population who have particular problems with health literacy?

Dr. Clancy: Typically, we see more limited health literacy among older adults, minorities, immigrants, poor families, and people with chronic mental and physical conditions. However, it’s really important to know that people, anyone can have difficulty with complex health information. Even well-educated people with strong reading and writing skills may have trouble understanding information and instructions about a medication or medical procedure that they’re going to have.

Rand: What are the greatest risks with not understanding your health information?

Dr. Clancy: Limited health literacy can literally harm a person’s health. Limited literacy plays an important role in health disparities and may contribute to lower quality care and even to medical errors. We have found that adults with lower-than-average reading skills and limited understanding of English are less likely than other Americans to get potentially life-saving screening tests such as mammograms and pap smears, to get flu and pneumonia vaccines, and to take their children for well-child care visits. AHRQ research also shows that people with limited literacy skills and limited understanding of English are more likely to have difficulty understanding informed consent forms, understanding their children’s diagnoses and following medication instructions.

Rand: So what can clinicians do to help bridge the gap for those with lower health literacy levels?

Dr. Clancy: First, it’s important for providers to identify patients with limited literacy levels and tailor their care and instructions to ensure that patients understand medical information. Use simple language, shorter sentences and define technical terms. Clinicians can also offer patients assistance with completing complex forms, and work with patients to find a translator if there’s a language barrier.

Rand: One final question for you. What can patients who are concerned about their health literacy do to get better health care?

Dr. Clancy: Ask questions! Then, make sure you get and understand the answers you need so that you fully understand your health information. Provide your clinician with enough information about your symptoms and medical history so that she can give you good care. In some cases, it might be helpful to have another adult with you, especially if there’s a language barrier or if you would like someone to advocate on your behalf, to speak up about your concerns. Overall, you want to promote good healthy communication with your doctor. This will go a long way to promoting your health literacy and, ultimately, your health. You need to be active in your health care and talk to everyone who takes care of you.

Rand: Dr. Carolyn Clancy, thank you for being with us.

Dr. Clancy: You’re welcome.

Rand: Up next, we’ll look at how pharmacists are promoting patient health literacy.


Debra: Is this medication supposed to be taken with or without food?If I need to take a pill every six hours, do I have to get up in the middle of the night to take one or can it wait until morning? More than a third of Americans adults struggle to understand how to take their medicines many due to their limited health literacy. But two new tools from AHRQ are designed to help pharmacists be more aware of health literacy challenges so they can help customers who might not understand what to do. Kara Jacobson, a primary investigator with the Pharmacy Intervention for Limited Literacy study, is with us today to explain the new AHRQ tools. Ms. Jacobson, welcome.

Ms. Jacobson: Thank you.

Debra: First, can you tell us a little bit about the new pharmacy tools?

Ms. Jacobson: Sure, we developed two tools. The first tool we created was a pharmacy assessment tool which allows an organization to assess how health literacy friendly they are. It is also designed to raise staff awareness of health literacy. After conducting an assessment, organizations can identify opportunities for improving how they communicate and the services they provide. The second tool is a training program for pharmacy staff that includes Power Point slides and a small group breakout discussion module where participants can role-play. The goal of the training curriculum is to assist pharmacists in better communication techniques with individuals who have limited health literacy.

Debra: How does limited health literacy affect patients and their use of prescription medications?

Ms. Jacobson: Limited health literacy adds to a patient’s risk. Studies show that people with limited health literacy are 12 to 18 times more likely to be unable to identify their own medications or distinguish them from one another. Individuals with limited health literacy also are less likely to understand potential side effects from their prescriptions and are more likely to misinterpret prescription bottle warning labels.

Debra: So, in general, would you say that pharmacists play an important part in patient education?

Ms. Jacobson: Absolutely! Patient education is critical. Ensuring that all people, especially those with limited health literacy, understand how to take their medications safely is vital to reducing medical errors and improving health care quality.

Debra: Ms. Jacobson, thanks for joining us.

Ms. Jacobson: It’s my pleasure.

Debra: Both pharmacy tools are available online at www.ahrq.gov/qual. The assessment tool is titled "Is Our Pharmacy Meeting Patients’ Needs? A Pharmacy Health Literacy Assessment Tool User’s Guide." The training program is titled "Strategies to Improve Communication between Pharmacy Staff and Patients: A Training Program for Pharmacy Staff."


Rand: That’s it for this week. For more information on these and other health-related stories and topics go to www.ahrq.gov.

Debra: Healthcare 411 is produced by AHRQ, the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services. For Rand Gardner, I’m Debra James. Please join us for the next edition of Healthcare 411.

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