- Health Literacy (HL) is an important component of safe and effective medicines use.
- Low health literacy is highly prevalent456, presenting a significant public health burden.
- Low HL is a risk factor for poor understanding of treatment, lower adherence, higher rates of hospitalization after discharge, and poorer overall health.78
- Pharmacists report higher drug errors with low HL patients.9
- Low HL also creates barriers to engagement between patient and health care professional, and self-care.1011
- A Universal Precautions (UP) strategy is a validated process to mitigate these risks. There are clear, evidence-based strategies for UP implementation.12
- It is important for the pharmaceutical industry to communicate effectively to ensure safe and effective medicines use.
- Pfizer Inc. has an established interest in Health Literacy strategies, including supporting the development of the of the Newest Vital Sign screener.13
To develop and test a Health Literacy education program for community pharmacists to enhance counselling and reduce medicines risk.
Using expert input and drawing on the HL evidence base and validated HL interventions a structured educational model was developed. The core elements aligned with those described in other work14. Specifically:
- a meaningful and practical definition of HL
- an overview of its importance and impact on health outcomes
- the patient experience of low HL
- an introduction to the concept of UP in HL
- strategies to reduce risk in particular "what questions you have?" and "teach back"
The core resource was developed as a face-to-face training session with breakouts to role-play the techniques, reflecting research demonstrating the importance of practice and peer support. Supporting collateral materials were also prepared.
What is teach-back?
- Ask your patient to say in their own words what they know or understand.
- If they can’t do this, repeat the information and ask them again to explain.
- This can initially seem awkward, but is very effective!
- Teach-back shifts the responsibility for error from the patient to the healthcare professional.
“Just to make sure I haven’t missed any important points, could you explain back to me how you are going to use this medicine?”
A number of Health Literacy training resources were created:
- A workshop slide set resource structured to deliver the following learning objectives:
- Describe health literacy and its impact
- Understand why it’s relevant for your pharmacy and your patients
- Feel confident in using the teach-back technique
- Have ideas and resources to enhance your store and services for patients with low health literacy
- Detail aid and fact sheet based on this information and used as quick guides to Health Literacy.
- A short animated video that gives an introduction to the issues around Health Literacy and how to address them
- Training was piloted with the Indian Pharmaceutical Association for 150 pharmacists, with further trainings scheduled in 2018.
- Further training was undertaken at the Medical Information Learning and Educational Services (MILES) meeting for Partner4Better in Kalyan, India on 28 April 2018.
- A version was adapted for Pfizer medical staff to enhance HL knowledge and establish a trainer network for wider implementation.
- Pilot data shows that learning objectives were met, with the content being relevant and well-received.
A well described structured program for Universal Precautions in Health Literacy was identified, that lent itself to practical implementation for the education of pharmacists to improve patient counselling.
Visiting Lecturer/Researcher, University of Westminster (and Studio Health Consultancy), London, UK ↩︎
Senior Research Fellow, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia ↩︎
Senior Director, US/Global Medical Affairs, PEH, Pfizer Inc., New York, United States ↩︎
Australian Bureau of Statistics, 2006 ↩︎
Sørensen et al., 2012 ↩︎
Kutner et al., 2006 ↩︎
Frisch et al., 2011 ↩︎
Mitchell et al., 2012 ↩︎
Koster et al., 2016 ↩︎
Batterham et al., 2014 ↩︎
von Wagner et al., 2009 ↩︎
Paasche-Orlow & Wolf, 2007 ↩︎
Weiss et al., 2005 ↩︎
Mihalopoulos et al., 2013 ↩︎
AHRQ, 2017 ↩︎