Transcript Effective Use of “Play It Safe…With Medicine!” AAFP Toolkit and

Effective Use of “Play It
Safe…With Medicine!”
AAFP Toolkit and Health Literacy
Resources
Charles P. Mouton, MD, MS
Professor, Dept of Community and Family Medicine
Howard University College of Medicine
2008
OBJECTIVES
• Upon completion of this session participants will
be able to:
– Implement improved methods of verbal and written
communication
– Assist patients in understanding how to take
medications as prescribed
– Incorporate practical strategies to create a shamefree environment
– Assess health literacy using clinically validated
instruments
– Determine readability of documents using the FleschKincaid reading level
Issue of Health Literacy
• Functional health literacy is a measure of
a person’s capacity to function effectively
in the health care setting as determined
by their comprehension of written health
care materials and by their ability to
understand and act on numerical health
care instructions
• up to 50% of the U.S. population has
some level of health ILLITERACY
HEALTH ILLITERACY
• associated unfavorable health outcomes:
– higher prevalence of chronic diseases
– greater use of emergency care
– higher incidence of hospitalization and longer
hospital stays
– higher incidence of unfavorable reactions to
prescribed medications
• TRANSLATION: $$$
Health Literacy in the Office Setting
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Impacts doctor-patient communication
Impacts adherence to treatment plans
Impacts patient satisfaction
Leads to poor quality indicators
Leads to unnecessary hospitalizations
Health literacy researchers have recommended
that prevention efforts to educate and improve
treatment of chronic disease, especially in low
literacy patients should be designed and
implemented
Toolkits
Useful to improve health literacy patients around
medication usage
PLAY IT SAFE with Medicine
Components:
Patient Education Brochure: English &
Spanish
Education CDs: Patient &Physician
Prescription pad sample
Pill Bottle stickers
Demonstration pill box
Patient Education Brochures
100 English and 50 Spanish
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Word Meaning
“Patient Power”
Understanding how to take medication
Medication Safety ideas
Education CDs
• Patient Education DVD
– Meant to be played in waiting room
• Physician Education
– The ETHNIC mnemonic to assist you in
interviewing patients
– A listing of cultural considerations
– Resources
Other stuff
• Prescription Pad Sample Cover
– Adds language to Rx for labeling
• Cartoon pill bottle stickers
– Heart, lung, stomach, hand, diabetes (sugar)
• Pill Box for demonstration
AMA Foundation Toolkit
Health literacy and patient safety:
Help patients understand
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DVD instructional video
CD-ROM educational video
Tear off educational pads for doctor visits
Campaign Buttons
Manual for Clinicians
Survey Instruments
• TOFHLA
– Test of Functional Health Literacy in Adults
• REALM
– Rapid Estimate of Adult Literacy in Medicine
• Newest Vital Sign
Rapid Estimate of Adult Literacy in
Medicine
• Developed in early 1990’s by Davis and
colleagues
• Comparable to formal reading
assessments ( corr coef 0.8-0.9)
• Cronbach’s alpha 0.96
EXAMPLE: pg 18
Newest Vital Sign
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Developed by Weiss et al. in 2005
Comparable to TOFHLA
Corr coef of 0.64
Cronbach’s alpha of 0.78
• EXAMPLE: pg 20
Flesch-Kincaid Reading Level
• The Flesch-Kincaid Reading level measures textual
difficulty and tells you the grade level of a text.
• The Flesch-Kincaid index tells how easy something is to
read. It does this by counting the number of syllables in
every word and the number of words in every sentence.
• The formula used to calculate the level is as follows:
(0.39 x Average No. of words in sentences) + (11.8 x
Average No. of syllables per word) - 15.59
• The number will represent a grade-school level
– For example, a sentence with a score of 8.0 means that
someone in 8th grade could understand. Normal writing is
usually between a 7 and an 8.
EXAMPLE
Conclusion
• Health literacy is important to patient
safety and good quality of care
• Physician offices need to be prepared to
assist their patients with health illiteracy
• Simple toolkits are available from AAFP
and AMA
• Simpler test of literacy are available
• Educational material need to have a
reading level appropriate for patients