Medicines non-adherence: adult literacy and implications for practice

Functional health literacy is defined as the level at which individuals can obtain, process and understand basic health information (Martin et al, 2009). Government statistics suggest low functional health literacy is an under-recognised and growing problem in UK health care. It is associated with high hospitalisation (Baker et al, 1998) and increased medicines non-adherence (Kalichman et al, 1999). Health professionals are poor at assessing and identifying those at risk because they have yet to acknowledge the prevalence of the problem. Initiatives attempting to address medicines non-adherence promote patient involvement in treatment decisions but remain ineffective if patients cannot read or understand written instructions. To help patients with low functional health literacy practitioners should speak slowly, repeat information, use plain, non-medical language and adopt teach-back techniques. These actions take extra time but are relatively easy to adopt and with a little thought become part of everyday practice.