In the age of easily accessible data, health literacy has proven to be a valuable resource for the effective functioning of healthcare systems. Currently, most countries, as well as pharma, are moving towards patient-centred healthcare; but, the complexity of most healthcare systems requires that patients and healthcare providers read and understand important health information. The need for literacy at virtually every stage of the health services chain highlights its importance and the need for dissemination of, and education about, such information for improvements in healthcare quality.
What is health literacy?
The term health literacy describes the spectrum of outcomes achieved through health education and communication activities. Several definitions of the concept exist, but, the following definition encapsulates the sheer importance of literacy as a necessary skill for health and well-being:
“[Health literacy is] the wide range of skills, and competencies that people develop to seek out, comprehend, evaluate and use health information and concepts to make informed choices, reduce health risks and increase quality of life.”
As highlighted by the World Health Organisation (WHO), literacy is more than reading health pamphlets and booking appointments with healthcare providers. It goes beyond the narrow concept of health education and communication that targets individual behaviour. Instead, WHO explains that the scope of literacy includes three distinct levels.
- Functional literacy: Includes skills such as reading and comprehension, which promote self-care and medication adherence, allowing an individual to function in society.
- Conceptual literacy: Encompasses the skills acquired and developed in an individual’s lifetime, which aid in making appropriate, informed health decisions, to improve quality of life.
- Health literacy as empowerment: Entails informed consumers with strengthened, active citizenship involvement in health promotion and disease prevention, as well as active advocacy in navigating the healthcare system.
An aggregation of these components makes literacy a skills-based process, capable of addressing the political, environmental, and socio-economic factors that affect health.
The importance of health literacy
A case study published by the Institute of Medicine illustrates the importance of literacy. In the study, a 29-year-old woman of African-American descent was brought to an emergency department in Baltimore by her family. The patient’s history comprised an occurrence of abdominal pain and fever for three days; assessments indicated that she would need to undergo exploratory laparotomy. Upon hearing the required management, specifically the word ‘exploratory,’ the woman became agitated and demanded to be taken home, claiming that she wouldn’t be subjected to any experimentation. She refused care and later died of appendicitis. This is an extreme case, but highlights the fundamental need for clear health information delivery, and an understanding of how literacy impacts health outcomes.
According to the UNESCO Institute for Statistics (UIS), approximately 15% of the global adult population lacked basic literacy skills in 2014. Therefore, this significant portion of the population lacks the skills needed to manage their own health and prevent disease. In addition, limited literacy increases the risk of poorer health outcomes due to medication errors, poor understanding of disease and treatment options, and reluctance to use preventive care.
The damaging effects of low literacy
Several studies assessing health-related materials, like medication package inserts and informed consent forms, reveal that such materials are, generally, very difficult to understand. The heavy use of technical language in these materials is a disadvantage for people with limited literacy. Furthermore, healthcare providers generally overestimate the literacy levels of their patients. They often use medical jargon, resulting in patients being reluctant to ask for clarification. A patient’s ability to self-manage their health and well-being, and any chronic diseases they may have, is hampered by the complicated dissemination of the information.
Pharma and the literacy problem
The patient-physician relationship is key within every healthcare system, and health information plays a crucial role in facilitating and maintaining this relationship. Pharma are increasingly expected to be a reliable source of health information and disease management, and therefore pharma’s role entails the provision of quality-assured and accurately fact-checked health information to both patients and physicians. This is crucial to the promotion of health literacy and improved health outcomes.
Low medication adherence due to low literacy costs pharma millions of dollars. In situations where patients do not understand how to take their medications, they either take them incorrectly or completely avoid taking them. The Centers for Disease Control and Prevention (CDC) has collated research data that discusses the growing body of evidence regarding how literacy affects health outcomes, as well as patient activation. In other words, by providing clear health information that is suitable to people of all literacy levels, healthcare providers, including pharma, can improve not only patient loyalty, but also medication and service adherence.
Pharma’s solution to low literacy
The challenge for pharma remains to communicate effectively and to provide health information in a language that patients can understand. With the increasing demand for better access to health information so that patients can play a more active role in managing their health, pharma can meet this demand by providing reliable information, which makes use of language that is void of industry terminology. Patient-centric interventions, such as rewriting medication information booklets, can improve literacy. Companies, such as Pfizer, who began their Clear Health Communication initiative in 2006, have moved to revise and rewrite thousands of pages of health materials, while a recent collaboration between Merck, Northwestern University, and Emory University, has led to an improvement in patient package inserts.
Empowering patients to make informed decisions
Pharma can continue to improve adherence to treatment by developing effective patient compliance strategies, based on progressive patient education. By putting themselves in the patient’s shoes, pharma can determine what information a patient will need at each step of their treatment journey. Indeed, the importance of the pharmaceutical industry’s role in improving literacy cannot be overemphasised. Reaching patients with vital and understandable information can empower them to make informed decisions about their health, resulting in improved health outcomes.