What Did the Doctor Say? Health Literacy and Recall of Medical Instructions

McCarthy, Danielle M.; Waite, Katherine; Curtis, Laura M.; Engel, Kirsten G.; Baker, David W.; Wolf, Michael S.

doi:10.1097/mlr.0b013e318241e8e1

Cited by 175 publications

(123 citation statements)

References 37 publications

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“…However, both English-and Spanish-speaking patients likely rely heavily on verbal communication and instructions given during the office visit, and this may particularly be true for patients with low health literacy. 17 For example, patients with low health literacy often compensate with greater reliance on the physician for health information. 18 As expected, health literacy levels were lower among Spanish-speaking patients in our study, but we did not find any significant difference in the recall of medications.…”

Section: Discussionmentioning

confidence: 99%

Association of Patient Recall, Satisfaction, and Adherence to Content of an Electronic Health Record (EHR)-Generated After Visit Summary: A Randomized Clinical Trial

Pavlik

Brown

Nash

et al. 2014

The Journal of the American Board of Family Medicine

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Objective: Most electronic health record (EHR) systems have the capability of generating a printed after-visit summary (AVS), but there has been little research on optimal content. We conducted a qualitative study and a randomized trial to understand the effect of AVS content on patient recall and satisfaction.Methods: Adult primary care patients (n ‫؍‬ 272) with at least 1 chronic condition were randomly assigned to 4 AVS content conditions: minimum, intermediate, maximum, or standard AVS. Demographics and health literacy were measured at an index clinic visit. Recall and satisfaction were measured by telephone 2 days and 2 to 3 weeks after the clinic visit.Results: Average age was 52 years; 75% of patients were female, 61% were Hispanic, and 21% were African American, and 64% had adequate health literacy. Average medication recall accuracy was 53% at 2 days and 52% at 3 weeks, with no significant difference among groups at either time. Satisfaction with AVS content was high and did not differ among groups. Recall of specific content categories was low and unrelated to group assignment. Health literacy was unrelated to recall and satisfaction. Supplying patients with printed instructions and information when they leave a medical encounter has become common practice. Before the availability of electronic health records (EHRs), patient educational materials often took the form of handouts and pamphlets and sometimes videos or interactive computer programs. Most EHRs enable clinicians to supply patients with individualized information in the form of an after visit summary (AVS) based on data available in patients' medical records. Recent legislation has all but required this feature to be included in the EHR for eligibility for financial incentives by meeting the Centers for Medicare and Medicaid Services' (CMS) Meaningful Use (MU) guidelines for the AVS.1 Core Measure 13 describes the objective to provide to patients clinical summaries about each office visit. According to §495.6(d)(13)(ii), the expectation is for, "Clinical summaries provided to patients for more than 50% of all office visits within 3 business days." 2The minimum set of elements recommended by CMS to achieve stage 1 of MU includes patient The EHR-generated AVS represents a potentially efficient and effective tool to support a variety of objectives for optimal patient outcomes in primary care. The majority of adult patients are followed for chronic conditions, such as hypertension and type 2 diabetes, which require long-term adherence to self-management behaviors. The concept of patient activation as a central factor in effective chronic disease self-management underlies many current behavioral interventions to improve outcomes. 3,4 In this conceptualization, the activated patient is provided with useful information about his or her condition(s), uses this information to undertake the recommended treatment plan, and engages with the provider in shared decision making to achieve desired health outcomes. The AVS can be viewed as a communication cha...

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Section: Discussionmentioning

confidence: 99%

Association of Patient Recall, Satisfaction, and Adherence to Content of an Electronic Health Record (EHR)-Generated After Visit Summary: A Randomized Clinical Trial

Pavlik

Brown

Nash

et al. 2014

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

show abstract

“…24,25 From this point of view, limited health literacy produces a vicious cycle, which engenders professional dominance and patient disengagement. 26 Actually, patients living with limited health literacy are likely to: exhibit impaired ability to recall health information, 27 perceive low self-efficacy in understanding and using prescription medication, 28 be unable to devise appropriate strategies to improve medication usage, 29 reveal health exacerbation, 30 show repeated and serious medication errors, and cause high medical expenses. 31 Several studies have discussed health literacy as a significant barrier to medication adherence, 32,33 although other scholars support that the relationship between these two dimensions is not clear.…”

Section: Simondsmentioning

confidence: 99%

Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

Palumbo

2015

Int J Health Policy Manag

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Background: Scholars describe poor health literacy as a "silent epidemic, " which is challenging the functioning of healthcare systems all over the world. Health literacy is mainly meant as an individual trait which concerns the ability to obtain, process, and understand basic health information in order to effectively navigate the health system. Low health literate patients perceive poor self-efficacy dealing with their health conditions, are not willing to be involved in the provision of care, show larger risks of hospitalization and mortality, and are not aware about the determinants of well-being. Hence, limited health literacy has been associated with inadequate management of long-term conditions; nonetheless, several authors argue that health literacy has been an overlooked factor dealing with HIV. Methods: This study is aimed at discussing the effects of poor health literacy on people living with HIV, drawing from the findings of a narrative literature review which involved 41 papers retrieved from the databases "Scopus-Elsevier" and "PubMed. " Results: The scientific literature is not consistent dealing with the relationship between health literacy and HIV treatment. For example, health literate patients seem to better understand their health conditions; on the other hand, people living with poor health literacy are likely to report higher compliance with providers' prescriptions, blindly trusting healthcare professionals. Conclusions: Poor health literacy is a social barrier to access healthcare services and to appropriate health treatment among patients living with HIV. Tailored interventions should be aimed at enhancing the health skills of patients affected by HIV infection to improve their ability to navigate the health system.

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“…A previous study [24] investigated patients' health literacy skills and recall of spoken medical instructions. It showed that the majority of patients had adequate health literacy, and that they could correctly recall spoken information.…”

Section: Discussionmentioning

confidence: 99%

Complaints concerning communication reported by users of healthcare in a specific region in Sweden

Hadziabdic

Higginbottom

2015

JHA

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Introduction: Effective communication between patients and healthcare staff is important in all healthcare services. Previous studies investigating criticism and complaints concerning treatment reported by patients and relatives in a healthcare context point to the most common complaints were unsatisfactory information, unsatisfactory respect and unsatisfactory empathy, but further investigation is needed. Objective: The aim of this study was to explore complaints reported by patients and relatives in a county council area in the context of communication between patients and healthcare staff, and to investigate the impact complaints can have on the safety and quality of healthcare. Methods: An exploratory descriptive design was used with a participatory approach. 115 complaints from patients and relatives, collected from various contexts relating to healthcare, were analyzed through qualitative content analysis. Results: Four categories emerged from the analysis of complaints: 1) inadequate communication; 2) inadequate individualistic and holistic healthcare; 3) unprofessional attitude of healthcare staff; and 4) the complaints had both a negative and positive impact on the organization of healthcare. The study showed that complaints were related to a lack of adequate verbal and written communication, the patients' feelings that the healthcare staff did not taking their experiences seriously, and an unprofessional, indifferent and discriminatory attitude among the healthcare staff. The complaints had both a negative and positive impact on the organization of healthcare. Conclusions: This study highlights how it is possible to learn from complaints about healthcare, and demonstrates that this is a prerequisite for improving healthcare practice. Knowledge about where healthcare practice is failing can be increased, and this can be fed into policies for patient safety and quality healthcare.

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What Did the Doctor Say? Health Literacy and Recall of Medical Instructions

Cited by 175 publications

References 37 publications

Association of Patient Recall, Satisfaction, and Adherence to Content of an Electronic Health Record (EHR)-Generated After Visit Summary: A Randomized Clinical Trial

Association of Patient Recall, Satisfaction, and Adherence to Content of an Electronic Health Record (EHR)-Generated After Visit Summary: A Randomized Clinical Trial

Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

Complaints concerning communication reported by users of healthcare in a specific region in Sweden

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