Health literacy is emerging as a systemic problem. The big statistic that you hear in this area is that nearly half of all American adults – 90 million people – have difficulty understanding and using health information, and there is a proven higher rate of hospitalisation and use of emergency services among patients with limited health literacy (Health Literacy: A Prescription to End Confusion report from the Institute of Medicine).
Bringing it closer to home the recent Aston Medical Adherence study (AMAS) found that a third of all patients in the UK fail to take their medicines properly due to poor understanding of doctors’ instructions and concerns over possible side effects. This is estimated to cost the NHS about £500m/yr.
This is a major and growing problem, sitting in the context of health authorities being pressurised to reduce avoidable hospital admissions and patients having greater responsibility for their own treatment at home. But how can this be resolved?
There are many papers, forums and panels all recommending big change programmes requiring a concerted effort from public health and health care systems, the education system, the media, and consumers to improve the nation’s health literacy. This is a problem that may require a number of significant solutions as one approach rarely solves all in cases like these.
However, could there be a simple solution that could make a big impact here now (as these other solutions are going to take a long time to take effect)? In all the literature that I have read recently I’ve hardly seen it mentioned that the actual instructions for use (IFUs) could be improved to help this issue. Surely this is a fundamental place to start – could it even be seen as a quick fix?
IFUs are renowned for being poor and full of information that the user doesn’t see as directly relevant in helping them understand how to use the device and take their medicine. Information about side effects and contraindications, etc. are obviously essential, but could the focus have possibly gone too far in telling people what not to do, focusing on preventing misuse and use error, that we’ve forgotten how to make sure people know what they should actually do?
In a previous article, Alison Black, Director of the Centre for Information Design Research at University of Reading, highlighted research that demonstrates how poorly people interact with IFUs – rarely reading two sentences consecutively, often ignoring introductory text and starting to use the product before they finish reading the IFU. I’m sure we can all recognise this behaviour, so surely improving IFUs is an essential and fundamental next step – you could even say the low hanging fruit option?
So, is it possible to;
The answer to all these questions is yes. And could this have an impact on the systemic issue of low health literacy by making IFUs more accessible? We think so, it won’t solve the whole problem but it will reduce it and the best part is this is something that can be done right now with just a little insight and the right resource.
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