Enhancing Patient Literacy on Calcium Supplementation: A Quality Improvement Initiative

This study aims to assess patients' knowledge and identify barriers in interpreting calcium on supplement and nutrition labels and to determine whether education would be beneficial.

Patients with conditions requiring calcium supplementation were included in this study. Participants were first given a 9-question pre-education survey. They were then taught how to read calcium on labels using the educational cards developed. This was followed by a 7-question posteducation survey. Endocrinologists were surveyed to assess their experience in treating patients who required calcium supplementation.

Before education, 31 (33%) and 37 (40%) of the participants felt that the supplement and nutrition labels, respectively, were confusing. After education, only 2 (2%) and 6 (6%) of the participants, respectively, still felt the same. There was a significant improvement in the interpretation of calcium citrate (Citracal) and calcium carbonate (TUMS) labels, with a trend of improvement in reading a milk label. Of the 47 endocrinologists surveyed, only 5 (11%) felt that their patients often or always knew the correct amount of calcium to be taken. Two-thirds 30 (64%) of the endocrinologists always or often explained to their patients how to interpret calcium labels. About half 23 (49%) of the endocrinologists always or often needed to take time to look up the calcium content of supplements. For most endocrinologists 29 (62%), this took at least 2 to 4 minutes.

Our patients had trouble interpreting calcium labels, and the use of educational cards was effective in improving calcium literacy.