How health literate are your patients?

pharmacist on the phone, ostensibly to the Pharmacists' Support Service

Pharmacists can’t assume their patients are equipped to make good health decisions, writes Ben Basger

How health literate are your patients?

Health literacy is the ability to access, understand and use basic health information, including being able to navigate health services and to make informed health decisions [1].

Do you think your patients have a basic level of knowledge and skills thereby allowing them to adhere to advice? Or perhaps they are more advanced than this and have cognitive skills which allow them to take a more active patient role?

Perhaps they have the highest quality of health literacy, allowing them to critically analyse and use information to exert greater control in health care decision making?

Unfortunately, only about 40% of adults have the level of individual health literacy needed to meet the complex demands of everyday life [2].

This means that only about 40% of adults can understand and follow health messages in the way in which they are usually presented, including prescription label instructions.

This is of particular concern, as the medicine container label is the most tangible and repeatedly used source for referring to prescription drug instructions by patients. It also means that only about 40% of adults will be able to make good choices based on a thorough understanding of the issues they face and the choices available.

Low individual health literacy is associated with higher rates of hospitalisation and emergency care, and with higher rates of adverse outcomes generally. It is also associated with lower health status and lower uptake of preventive approaches such as mammography and vaccination against influenza and pneumonia [2].

This problem can be compounded by language barriers such as low English proficiency and patients from culturally diverse backgrounds.

Such patients are considered to be among the most vulnerable to suboptimal medicine use and health service utilisation. These barriers also affect patient satisfaction [1].

Many health care documents have been found to be above the readability standard of patients and it has been stated that good drug information documents should have:

  1. a clear purpose;
  2. limited scope;
  3. a summary/brief review;
  4. well-placed graphics;
  5. informative illustrations;
  6. clean layout and lucid formatting relevant to the medium; and
  7. a focus on the intended users [3].


Bearing all this in mind, do we make convenient assumptions about a patient’s level of understanding because of time constraints?

Perhaps we have become less aware of literacy issues?

It could be argued that if we were free to engage with patients instead of being tied to administrative/dispensing work, maybe this problem would disappear.

But of course this would also depend on our knowledge, communication skills and level of proactivity.




  1. Mohammad A, Saini B, Chaar BB. Exploring culturally and linguistically diverse consumer needs in relation to medicines use and health information within the pharmacy setting. RSAP. 2015;11:545-59.
  2. Australian Commission on Safety and Quality in Health Care. National Statement on Health Literacy. Accessed 23 Jun 2015.
  3. Gill PS. Prescription painkillers and controlled substances: an appraisal of drug information provided by six US pharmacies. Drug healthcare and patient safety 2013;5:29-36.


Ben Basger is a lecturer and tutor in pharmacy practice, Faculty of Pharmacy, The University of Sydney.

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