Health literacy is a barrier to realizing the full vision for a consumer-centric healthcare system," noted John Tooker, MD,
deputy executive vice-president and COO of the Ameri-can College of Physicians, at a recent meeting where Health and Human
Services Secretary Tommy Thompson announced the first part of the government's plan to establish a national health information
infrastructure. Doug Henley, MD, of the American Academy of Family Physicians agreed: "There is a recognition [among doctors]
that the amount of available data for a patient exceeds human capacity. We have to fess up to that."
With greater recognition of low literacy, physicians are looking for practical ways to enhance communication with their patients.
And pharma can lend a hand. Pfizer, for example, helped underwrite the Institute of Medicine report on health literacy and
continues to support the Partnership for Clear Health Communication initiative, which aims to improve patients' comprehension
of medical matters while they are in the doctor's office.
But few efforts are focused on helping providers help their patients understand how to take medicines once they are at home.
That's important because, if doctors can teach that skill, patients will become more compliant and persistent with their drug
regimens and reduce adverse events associated with taking medication incorrectly.
For example, instructions are difficult for people with limited literacy to understand. Let's say an infant with an ear infection
is prescribed an antibiotic, and the directions say to take the medication "orally." The term orally can be misunderstood
or not understood, and a parent may administer the antibiotic into the child's ear. Another example is when patients ingest
vaginal suppositories by mouth because they are not clear what a suppository is. Pharma companies assume that people understand—but
the truth is many don't. Consequently, they are not giving patients the ammunition they need to take action to change health
Supplying the Demand
Reps as Teachers
Healthcare professionals are hungry for the information. (See "Supplying the Demand.") I've presented the topic of patient
literacy and keys to compliance at pharma-funded training sessions, lunch and dinner meetings, medical education seminars,
and many other programs which providers attended in such large numbers that they left standing room only.
But companies can take health literacy programs to the next step by training reps in techniques that doctors can easily use.
Currently, Pfizer reps hand out materials for AskMe3, a component of its Clear Health Communicationinitiative that lays out
three questions patients can ask to better understand their health conditions. But pharma reps should remind doctors of other
techniques that could improve persistence and compliance.
Use simple language. Reps can discuss the importance of using easy-to-understand terms. Physicians should say "both sides" instead of "bilateral"
and "not cancerous" instead of "benign."
Visuals work. Consumers retain more information with visual aids. If a patient has to take a pill with "plenty of water," reps can suggest
providers show patients an eight-ounce glass of water or two full Dixie cups.
Write a prescription for healthy behaviors. Research shows that when providers write on a prescription pad "Stop smoking" or "Get active for 30 minutes three times each
week," patients take the directive more seriously.
Avoid too much information. Reps should encourage providers to summarize key points. Let them know it is helpful to offer a summary of the behaviors
in which they want the patient to engage.