Patient information too high for patients' literacy: New Australian research

"Our study suggests most patient information materials are not fit for their intended purpose, and that organisations are producing materials that may be too difficult for their intended audience to understand," said Angela Webster, lead researcher and an Associate Professor Clinical Epidemiology at the University of Sydney.

The average adult patient has an 8th grade literacy level but over 20 per cent of patients read at or below a 5th grade level. Of patients over the age of 65, 40 per cent read at or below a 5th grade level.

In the study, researchers looked at 80 English-language educational materials that were designed to be printed and read by patients in the United States, Australia and the United Kingdom. These free educational materials were analyzed using both the Lexile Analyzer and the Flesch-Kincaid Grade Level formula.

Analysis suggested that most materials required a minimum of a 9th grade health literacy level. Only 5 per cent of materials were pitched at the recommended 5th grade level.

"These findings suggested that patient information materials aimed at patients with chronic kidney disease are pitched well above the average patient's literacy level, so that most patients wouldn't be able to read and understand the health messages," Webster said.

Providing patients with reading materials outside their level of understanding could make it difficult to follow medication directives, dietary restrictions, and necessary lifestyle modifications for disease management.

Poor health literacy is a particular problem for elderly, ethnic minority, and socially disadvantaged people, all of whom are more likely to have chronic kidney disease.

People with low health literacy are less likely to feel engaged with their healthcare providers, and are less likely to participate in their treatment decisions and have significantly higher mortality and morbidity rates. Materials that are written above a patient's health literacy level can contribute to poor management and outcomes.

"Developing patient education materials that are appropriate for all literacy levels is a challenge, but a very important challenge for improving health outcomes. All organisations need to make a thorough assessment on the readability of their patient information materials," said Thomas Manley, Director of Scientific Activities for the National Kidney Foundation.

"Conducting formal readability testing, as suggested by the study authors, along with use of patient reviewers from a variety of educational and cultural backgrounds may provide important feedback to enhance the value of materials across a larger spectrum of health literacy levels."