20 April 2015
O
NE in six adults in Ireland (521,550
people) finds reading and under-
standing everyday texts difficult,
according to OECD research published
by the CSO in 2012. This includes read-
ing a leaflet, for example, or medicine
instructions. In addition, a significant
40% of Irish people have limited health
literacy according to the 2012 European
Health Literacy Study.
This means that four out of ten people
who use health services may find it diffi-
cult to understand and act on the health
information and advice they receive.
Irish Health Literacy Research (2015)
shows that 45% of people surveyed
were unable to define the term “progno-
sis”. A 2014 review, carried out by the
Royal College of General Practitioners
in the UK, found that patients usually
retain about half of the information
they receive in a consultation with their
healthcare professional. Only half of the
information that they do remember is
generally correct.
Health literacy and numeracy is about
the healthcare provider communicat-
ing health information clearly and the
patient understanding this information
correctly. This is crucial for people’s
health and wellbeing. The more effec-
tively that people can act upon health
information, the better their health out-
comes will be.
Health numeracy is the ability to
understand, use and act on numerical
information. Most health information
requires us to use basic numbers and
calculations.
We are, for example, expected to
manage our medication by reading and/
or hearing instructions, understanding
them, and working out doses. According
to the OECD research, one in four adults
in Ireland has difficulties in real-world
maths – from simple addition and sub-
traction to the calculation of averages.
A disturbing 17% of people surveyed in
the 2015 research said they had taken
the wrong amount of medication on at
least one occasion.
There are many reasons why people
have difficulties with health informa-
tion. There are factors such as literacy,
numeracy, needs, age, language, disa-
bility and culture. Specialised medical
language used by healthcare profes-
sionals when speaking to their patients
is another factor. People are often not
familiar with these medical terms and
it can be embarrassing to ask the doctor
to explain them in everyday language. A
further factor is that it is difficult to take
in information properly when receiving
worrying news about our health.
Medical jargon and emotional stress
effect our health literacy and we could
leave a consultation unclear about both
our condition and treatment.
Promoting good health literacy and
numeracy practices means that we can
make sound health decisions at home and
in the community. We can give informed
consent to treatment and follow dosage
instructions. We can understand how
to live with chronic health conditions.
We have the skills and confidence to ask
questions, and we can navigate health-
care systems effectively. This is in
everybody’s interests.
A Crystal Clear quality mark has just
been launched to respond to this issue.
This is the first ever such quality mark
and has been developed by the National
Adult Literacy Agency, along with the
Irish Pharmacy Union, the Irish Col-
lege of General Practitioners, and MSD
(a pharmaceutical company). A Crystal
Clear Pharmacy or General Practice deliv-
ers a quality service that takes account of
possible literacy and numeracy needs of
patients and consistently improves upon
the services they provide.
Getting the Crystal Clear quality mark
also recognises that the service regu-
larly evaluates and improves its health
literacy practices. An online audit tool
has been developed to assess the health
literacy and numeracy practices of phar-
macies and general practices (www.nala.
ie/crystalclear).
Healthcare providers need to take
steps to communicate in ways that all
their patients and patients can under-
stand. They should think about the
language they use when talking to
patients and try to explain things in eve-
ryday language. When they talk about
medication, they shouldn’t assume the
patient will understand quantitative
concepts or are familiar with the meas-
urements involved.
They should use teach-back, a way to
assess and confirm that people under-
st and what t hey have been told, by asking
them to repeat back the key information
in their own words and encouraging
patients to ask any questions that they
may have, after the repetition. •
Aoife O’Driscoll is Policy Officer with the
National Adult Literacy Agency
Crystal Clear is the cure for not
understanding what the doctor
told you. By Aoife O’Driscoll
Did she say
phlebotomy
or lobotomy?
Patients retain
about half the
information
they receive
in a medical
consultation
and only
half of the
information
they remember
is correct
“
prognosis...
proboscis...proctitis?
NEWS Crystal Clear