In 2003, the National Assessment of Adult
Literacy found that only 12% of Americans were proficient in health literacy. As defined by the Patient Protection and Affordable Care Act of 2010, health literacy is the “degree to which an individual has the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions.” By the basis of this definition, literacy rates do not directly correlate with health literacy rates. The fact that nearly 9 out of 10 Americans experience difficulty when using everyday health related information that is readily available sheds light on the need for interventions to improve communication.
Researchers have found that low health literacy can be a major contributing factor to poor medication adherence, which together, can impair treatment success for patients. Simply put, if patients are unable to understand what medications they are taking and how they should be taking them, clinicians cannot expect clinical benefits from their prescribed treatment regimens. It is in these instances that the utility of the pharmacist can be appreciated. As one of the most readily accessible health care providers, pharmacists are a in a unique position to improve provider-patient
communication and bridge any gaps in misunderstanding that are caused by health illiteracy. For example, upon discharge from a hospital, patients are often bombarded with packets of discharge paperwork, lists of medications and a stack of new prescriptions. One study that examined the
relationship between health literacy and hospital reutilization found that patients with low health literacy were more likely than patients with adequate health literacy to return to the hospital or emergency room within 30 days of discharge. If a pharmacist could determine the health literacy level of the patient and counsel accordingly, patients would be able to walk away with an enhanced understanding, which could provide the foundation for medication adherence and potentially reduce re-hospitalizations. The issue is that at this time, it is not so easy to determine what level of health literacy patients fall into so it would be especially difficult to determine this in a quick visit to a retail pharmacy. However, with improved patient-clinician interactions, health literacy levels could be determined more efficiently thereby paving the way for patient-specific solutions.
While there is no Hooked On Phonics approach to improve health literacy, steps have been made in the right direction. As an objective of Healthy People 2020, health literacy and the knowledge of its
barriers are getting an increasing amount of attention. As initiatives like the National Action Plan to Improve Health Literacy tackle the issue head on, clinicians can implement strategies to shorten the gap in misunderstanding and thereby improve health outcomes.
Anita A. Pothen, PharmD ‘14