Health Literacy and Cardiac Medication Education: A Quality Improvement Study Using Teach-Back

Limited qualitative research has explored clinician behaviors that enhance communication with patients who have limited health literacy (HL). Teach-back is a patient-centered strategy used to confirm understanding and close HL gaps.

This quality improvement initiative aimed to improve patient understanding of newly prescribed cardiac medications at discharge on a telemetry unit in a university-affiliated community hospital in New York. The goal was to increase the percentage of patients who understood the indication and side effects of their new medications to at least 85% by January 2024, using the Plan-Do-Study-Act framework.

Fifty eligible patients (mean age 71.7 years) admitted between November 2023 and January 2024 were considered. Inclusion criteria included a newly prescribed cardiac medication, intact cognition, English fluency, and discharge to home. Patients completed a baseline questionnaire assessing knowledge of medication purpose and side effects. Those with knowledge gaps received tailored education using plain language, followed by a teach-back session. Patients were asked to explain the medication's purpose and risks in their own words. Follow-up interviews 2-4 weeks postdischarge reassessed retention using the same framework.

At baseline, 54% of patients understood the medication's purpose, and only 26% were aware of potential adverse effects. After the intervention, 92% accurately explained both indication and side effects, and 74% retained the information at follow-up. Standardized protocols and blinded follow-up interviews helped minimize selection and reporting bias.

The teach-back method significantly improved patient comprehension and short-term retention of discharge medication instructions. It is a feasible, low-cost strategy that can be effectively implemented in inpatient cardiology settings to address HL-related communication gaps and support safer transitions of care.