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Anticoagulant patient information material is written at high readability levels
C A Estrada1, M M Hryniewicz, V B Higgs
1East Carolina University Anticoagulation Clinic, Clinical Information Support Office, University Health Systems, Greenville, North Carolina, USA. estradac@mail.ecu.edu.
Insights
Patient information on anticoagulants is too difficult for many to understand. Most brochures are written at a 10th-grade level, far above the recommended 6th-grade level for effective patient education.
Area of Science:
- Pharmacology
- Health Literacy
- Patient Education
Background:
- Warfarin therapy requires careful monitoring and dose adjustments.
- Elderly patients, especially those with atrial fibrillation or prior stroke, may struggle with complex medical information.
- Effective patient education materials are crucial for safe anticoagulant use.
Purpose of the Study:
- To assess the readability of patient information materials for anticoagulant therapy.
- To determine if current materials meet recommended literacy standards for patient comprehension.
Main Methods:
- The SMOG grade formula was used to measure the readability of 50 patient brochures.
- Brochures covered warfarin, atrial fibrillation, low-molecular-weight heparins, and related topics.
- Materials were sourced from industry, health advocacy groups, and the internet.
Main Results:
- The average readability level of the brochures was 10.7 grade.
- No brochures met the recommended 6th-grade reading level or below.
- 74% of materials were written at a 9th-12th grade level, and 14% were above 12th grade.
Conclusions:
- Patient education materials for anticoagulants are generally written at a reading level too high for most patients.
- There is a significant need for low-literacy patient brochures for individuals on anticoagulant therapy.
Background:
Warfarin therapy requires frequent monitoring and dose adjustment. Elderly patients with atrial fibrillation, prior stroke, and lower literacy skills may have difficulty reading brochures that explain dosing instructions, procedures to follow, and the risks and benefits of anticoagulants. In general, it is recommended that brochures be written at or below the 6th-grade level. We determined the readability of patient information material being offered to patients receiving anticoagulants.
Methods And Results:
We used the SMOG grade formula to measure readability of written patient materials. We obtained 50 brochures commonly used in anticoagulation management units from industry and health advocacy groups. Patient information was related to atrial fibrillation (16%, n=8), warfarin (44%, n=22), low-molecular-weight heparins (12%, n=6), or other related topics (28%, n=14). The mean readability was found to be grade 10.7 (95% CI 10.1 to 11.2); none had a readability score at the 6th-grade level or below, 12% of the brochures had readability scores at the 7th- to 8th-grade levels (n=6), 74% at the 9th- to 12th-grade levels (n=37), and 14% at higher than 12th-grade level (n=7). The readability grade level was similar for brochures produced by industry or health advocacy groups (P:=0.9) but higher for information obtained from the Internet (12.2+/-1.3 grades) compared with other sources (10.3+/-2.1 grades; P:=0.01).
Conclusions:
Patient education materials related to the use of anticoagulants are written at grade levels beyond the comprehension of most patients. Low-literacy brochures are needed for patients on anticoagulants.
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