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Providing health information to older adults

Published online by Cambridge University Press:  19 November 2010

Cheryl A Sadowski
Cheryl A Sadowski*
Affiliation:
Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Canada
*
Address for correspondence: Cheryl Sadowski, Associate Professor, Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, CanadaT6G 2N8. Email: csadowski@pharmacy.ualberta.ca
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Summary

Providing information to older adults is essential for informed decision-making and good health. Because there are significant deficits in providing information verbally, health professionals must use written information as well. Most studies have focused on the content and literacy of documents. However, the legibility and formatting are critically important for older adults, who are more likely to suffer with visual impairment. Providing written information that is tested for appropriate reading level and for presentation is necessary to ensure that older adults can use the information given. There are a number of tools available that test these aspects of written information, but not one tool that is universally accepted. Further research regarding the design and presentation of written information for older adults is necessary.

Keywords

informationpatient empowermentolder people
Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 21 , Issue 1 , February 2011 , pp. 55 - 66
Copyright
Copyright © Cambridge University Press 2010

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References

1Vieder, JN, Krafchick, MA, Kovach, AC, Galluzzi, KE. Physician–patient interaction: what do elders want? J Am Osteopath Assoc 2002; 102: 73–78.Google ScholarPubMed
2Dolovich, L.Ensuring that patients’ drug information needs are met. CJHP 2003; 56: 133–35.Google Scholar
3Radecki, SE, Kane, RL, Solomon, DH, Mendenhall, RC, Beck, JC. Do physicians spend less time with older patients? J Am Geriatr Soc 1988; 36: 713–18.CrossRefGoogle ScholarPubMed
4Buller, MK, Buller, DB. Physicians’ communication style and patient satisfaction. J Health Soc Behav 1987; 28: 375–88.CrossRefGoogle ScholarPubMed
5Bronson, DL, Costanza, MC, Tufo, HM. Using medical records for older patient education in ambulatory practice. Med Care 1986; 24: 332–39.CrossRefGoogle ScholarPubMed
6Smith, D. Taking Control of your Medicines. Consumer Health Corporation. 2001.Google Scholar
7Mitka, M. Drug package inserts get mixed reception. JAMA 2006; 295: 1110–11.Google ScholarPubMed
8Elwyn, G, Edwards, A, Britten, N. What information do patients need about medicines? ‘Doing prescribing’: how doctors can be more effective. BMJ 2003; 327: 864–67.CrossRefGoogle ScholarPubMed
9Ray, RE, Thomson, R. The importance of patient preferences in treatment decisions – challenges for doctors. BMJ 2003; 327: 542–45.Google Scholar
10Keller, VF, Carroll, JG. A new model for physician–patient communication. Patient Educ Couns 1994; 23: 131–40.CrossRefGoogle ScholarPubMed
11WHO. Adherence to long-term therapies. Evidence for action. World Health Organization; 2003.Google Scholar
12Blackwell, B. Drug therapy: patient compliance. N Engl J Med 1973; 289: 249–52.CrossRefGoogle ScholarPubMed
13Kagansky, N, Knobler, H, Rimon, E, Ozer, Z, Levy, S. Safety of anticoagulation therapy in well-informed older patients. Arch Intern Med 2004; 164: 2044–50.CrossRefGoogle ScholarPubMed
14Sheard, C, Garrud, P. Evaluation of generic patient information: effects on health outcomes, knowledge and satisfaction. Patient Educ Couns 2006; 61: 43–47.CrossRefGoogle ScholarPubMed
15Bouchard, RE, Tufo, HM. The patient and his problem-oriented record. In Walker, HK, Hurst, JW, Woody, MF (eds). Applying the Problem-Oriented System. New York: Medcome Press; 1973: 42–46.Google Scholar
16The NHS Plan. A plan for investment, a plan for reform. HMSO 2000. Available at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_118522.pdf. Accessed 1 July 2010.Google Scholar
17White, P, Singleton, A, Jones, R. Copying referral letters to patients: the views of patients, patient representatives and doctors. Patient Educ Couns 2004; 55: 94–98.CrossRefGoogle Scholar
18O'Neil, CK, Poirer, TI. Impact of patient knowledge, patient–pharmacist relationship, and drug perceptions on adverse drug therapy outcomes. Pharmacotherapy 1998; 18: 333–40.CrossRefGoogle ScholarPubMed
19Makaryus, AN, Friedman, EA. Patients’ understanding of their treatment plans and diagnosis at discharge. Mayo Clin Proc 2005; 80: 991–94.CrossRefGoogle ScholarPubMed
20King, JL, Schommer, JC, Wirsching, RG. Patients’ knowledge of medication care plans after hospital discharge. Am J Health Syst Pharm 1998; 55: 1389–93.CrossRefGoogle ScholarPubMed
21Calkins, DR, Davis, RB, Reiley, P, Phillips, RS, Pineo, KL, Delbanco, TL, Iezzoni, LI. Patient–physician communication at hospital discharge and patients’ understanding of the post-discharge treatment plan. Arch Intern Med 1997; 157: 1026–30.CrossRefGoogle Scholar
22Krumholz, HM. Informed consent to promote patient-centred care. JAMA 2010; 303: 1190–91.CrossRefGoogle Scholar
23Persell, SD, Heiman, HL, Weingart, SN, Burdick, E, Borus, JS, Murff, HJ, Bates, DW, Gandhi, TK. Understanding of drug indications by ambulatory care patients. Am J Health Syst Pharm 2004; 61: 2523–27.CrossRefGoogle ScholarPubMed
24Gray, SL, Sager, MA, Lestico, MR, Jalaluddin, M. Depression, cognitive impairment, and understanding of medication directions in hospitalized elderly patients. Pharm Res 1997; 14: 316–19.CrossRefGoogle ScholarPubMed
25Hughes, L, Whittlesea, C, Luscombe, D. Patients’ knowledge and perceptions of the side-effects of OTC medication. J Clin Pharm Ther 2002; 27: 243–48.CrossRefGoogle ScholarPubMed
26Wilkinson, IF, Darby, DN, Mant, A. Self-care and self-medication. An evaluation of individuals’ health care decisions. Med Care 1987; 25: 965–78.CrossRefGoogle ScholarPubMed
27McKain, S, Henderson, A, Kuys, S, Drake, S, Kerridge, L, Ahern, K. Exploration of patients’ needs for information on arrival at a geriatric and rehabilitation unit. J Clin Nurs 2005; 14: 704–10.CrossRefGoogle Scholar
28Flocke, SA, Stange, KC. Direct observation and patient recall of health behavior advice. Prev Med 2004; 38: 343–49.CrossRefGoogle ScholarPubMed
29Wilson, M, Robinson, EJ, Blenkinsopp, A, Panton, R. Customers’ recall of information given in community pharmacies. Int J Pharmacy Pract 1992; 1: 152–59.CrossRefGoogle Scholar
30Kalet, A, Roberts, JC, Fletcher, R. How do physicians talk with their patients about risks? J Gen Intern Med 1994; 9: 402–4.CrossRefGoogle ScholarPubMed
31Bogardus, ST Jr, Holmboe, E, Jekel, JF. Perils, pitfalls, and possibilities in talking about medical risk. JAMA 1999; 281: 1037–41.CrossRefGoogle ScholarPubMed
32Lerner, EB, Jehle, DV, Janicke, DM, Moscati, RM. Medical communication: do our patients understand? Am J Emerg Med 2000; 8: 764–66.CrossRefGoogle Scholar
33Hadlow, J, Pitts, M. The understanding of common health terms by doctors, nurses and patients. Soc Sci Med 1991; 32: 193–96.CrossRefGoogle ScholarPubMed
34O'Connor, AM, Bennett, CL, Stacey, D, Barry, M, Col, NF, Eden, KB, Entwistle, VA, Fiset, V, Holmes-Rovner, M, Khangura, S, Llewellyn-Thomas, H, Rovner, D. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2009; (3): CD001431.CrossRefGoogle Scholar
35Couldridge, L, Kendall, S, March, A. A systematic overview – a decade of research. The information and counselling needs of people with epilepsy. Seizure 2001; 10: 605–14.CrossRefGoogle ScholarPubMed
36Webber, GC. Patient education. A review of the issues. Med Care 1990; 28: 1089–103.CrossRefGoogle ScholarPubMed
37Fuller, R, Dudley, N, Blacktop, J. Risk communication and older people – understanding of probability and risk information by medical inpatients aged 75 years and older. Age Ageing 2001; 30: 473–76.CrossRefGoogle ScholarPubMed
38Shrank, W, Avorn, J, Rolon, C, Shekelle, P. Effect of content and format of prescription drug labels on readability, understanding, and medication use: a systematic review. Ann Pharmacother 2007; 41: 783–801.CrossRefGoogle ScholarPubMed
39Wolf, MS, Davis, TC, Bass, PF, Curtis, LM, Lindquist, LA, Webb, JA, Bocchini, MV, Bailey, SC, Parker, RM. Improving prescription drug warnings to promote patient comprehension. Arch Intern Med 2010; 170: 50–56.CrossRefGoogle ScholarPubMed
40Dyck, A, Deschamps, M, Taylor, J. Pharmacists’ discussions of medication side effects: a descriptive study. Patient Educ Couns 2005; 56: 21–27.CrossRefGoogle ScholarPubMed
41Robinson, TE 2nd, White, GL Jr, Houchins, JC. Improving communication with older patients: tips from the literature. Fam Pract Manag 2006; 13: 73–78.Google ScholarPubMed
42Philipp, R, Hughes, A, Wood, N, Burns-Cox, C, Cook, N, Fletcher, G. Information needs of patients and visitors in a district general hospital. J R Soc Health 1990; 110: 10–12.CrossRefGoogle Scholar
43Martens, KH. An ethnographic study of the process of medication discharge education (MDE). J Adv Nurs 1998; 27: 341–48.CrossRefGoogle ScholarPubMed
44Nelson, JE, Mercado, AF, Camhi, SL, Tandon, N, Wallenstein, S, August, GI, Morrison, RS. Communication about chronic critical illness. Arch Intern Med 2007; 167: 2509–15.CrossRefGoogle ScholarPubMed
45Whitehead, P, Atkin, P, Krass, I, Benrimoj, SI. Patient drug information and consumer choice of pharmacy. Int J Pharmacy Pract 1999; 7: 71–79.CrossRefGoogle Scholar
46Grymonpre, RE, Steele, JW. The medication information line for the elderly: an 8-year cumulative analysis. Ann Pharmacother 1998; 32: 743–48.CrossRefGoogle ScholarPubMed
47Smith, F, Francis, SA, Rowley, E. Group interviews with people taking long-term medication: comparing the perspectives of people with arthritis, respiratory disease, and mental health problems. Int J Clin Pract 2000; 8: 88–96.Google Scholar
48Fried, TR, Bradley, EH, O'Leary, J. Prognosis communication in serious illness: perceptions of older patients, caregivers, and clinicians. J Am Geriatr Soc 2003; 51: 1398–403.CrossRefGoogle ScholarPubMed
49Dickinson, D, Raynor, DK. What information do patients need about medicines? Ask the patients – they may want to know more than you think. BMJ 2003; 327: 861.CrossRefGoogle Scholar
50Nair, K, Dolovich, L, Cassels, A, McCormack, J, Levine, M, Gray, J, Mann, K, Burns, S. What patients want to know about their medications. Focus group study of patient and clinician perspectives. Can Fam Physician 2002; 48: 104–10.Google ScholarPubMed
51Ziegler, DK, Mosier, MC, Buenaver, M, Okuyemi, K. How much information about adverse effects of medication do patients want from physicians? Arch Intern Med 2001; 161: 706–13.CrossRefGoogle ScholarPubMed
52Berry, D, Gillie, I, Forster, M. What do patients want to know about their medicines and what do doctors want to tell them? A comparative study. Pyschol Health 1997; 12: 467–80.CrossRefGoogle Scholar
53Grime, J, Blenkinsopp, A, Raynor, DK, Pollock, K, Knapp, P. The role and value of written information for patients about individual medicines: a systematic review. Health Expect 2007; 10: 286–98.CrossRefGoogle ScholarPubMed
54Tarn, DM, Heritage, J, Paterniti, DA, Hays, RD, Kravitz, RL, Wenger, NS. Physician communication when prescribing new medications. Arch Intern Med 2006; 166: 1855–62.CrossRefGoogle ScholarPubMed
55Ong, LM, de Haes, JC, Hoos, AM, Lammes, FB. Doctor–patient communication: a review of the literature. Soc Sci Med 1995; 40: 903–18.CrossRefGoogle ScholarPubMed
56Schommer, JC, Doucette, WR, Worley, MM. Processing prescription drug information under different conditions of presentation. Patient Educ Couns 2001; 43: 49–59.CrossRefGoogle ScholarPubMed
57AHRQ. 20 Tips to help prevent medical errors: Patient fact sheet. Rockville, MD: Agency for Healthcare Research and Quality; February 2000; AHRQ publication 00-P038. http://www.ahrq.gov/consumer/20tips.htm (accessed 1 July 2010).Google Scholar
58AHRQ. Quick Tips – When Getting a Prescription. Rockville, MD: Agency for Healthcare Research and Quality; May 2002. AHRQ Publication 01–0040c. http:www.ahrq.gov/consumer/quicktips/tipprescrip.htm (accessed 1 July 2010).Google Scholar
59Nathan, JP, Zerilli, T, Cicero, LA, Rosenberg, JM. Patients’ use and perception of medication information leaflets. Ann Pharmacother 2007; 41: 777–82.CrossRefGoogle ScholarPubMed
60Koo, MM, Krass, I, Aslani, P. Factors influencing consumer use of written drug information. Ann Pharmacother 2003; 37: 259–67.CrossRefGoogle ScholarPubMed
61Speros, CI. More than words: Promoting health literacy in older adults. OJIN 2009; 14: p6.CrossRefGoogle Scholar
62Wilson, FL. Are patient information materials too difficult to read? Home Healthc Nurse 2000; 18: 107–15.CrossRefGoogle ScholarPubMed
63McLaughlin, H. SMOG grading – a new readability formula. J Reading 1969; 12: 639–46.Google Scholar
64Kincaid, J, Fishburn, R, Rogers, R, Chissom, B. Derivation of new readability formulas for navy enlisted personnel. Millington, TN: Memphis Naval Air Station, 1975.Google Scholar
65Flesch, R. A new readability yardstick. J Appl Psychol 1948; 32: 221–33.CrossRefGoogle ScholarPubMed
66Davis, TC, Crouch, MA, Long, SW, Jackson, RH, Bates, P, George, RB, Bairnsfather, LE. Rapid assessment of literacy levels of adult primary care patients. Fam Med 1991; 23: 433–35.Google ScholarPubMed
67Parker, RM, Baker, DW, Williams, MV, Nurss, JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med 1995; 10: 537–41.CrossRefGoogle ScholarPubMed
68Andrus, MR, Roth, MT. Health literacy: a review. Pharmacotherapy 2002; 22: 282–302.CrossRefGoogle ScholarPubMed
69Davis, TC, Crouch, MA, Wills, G, Miller, S, Abdehou, DM. The gap between patient reading comprehension and the readability of patient education materials. J Fam Pract 1990; 31: 533–38.Google Scholar
70Marcus, EN. The silent epidemic – the health effects of illiteracy. N Engl J Med 2006; 355: 339–41.CrossRefGoogle ScholarPubMed
71Breese, P, Burman, W. Readability of notice of privacy forms used by major health care institutions. JAMA 2005; 293: 1593–94.Google ScholarPubMed
72Doak, CC, Doak, LG, Root, JH. Teaching patients with low literacy skills. Philadelphia, PA: JB Lippincott Company; 1996.CrossRefGoogle Scholar
73Duman, M. Producing patient information: how to research, develop, and product effective information resources. London, UK: King's Fund; 2003.Google Scholar
74Buck, ML. Providing patients with written medication information. Ann Pharmacother 1998; 32: 962–69.CrossRefGoogle ScholarPubMed
75Petterson, T. How readable are the hospital information leaflets available to elderly patients? Age Ageing 1994; 23: 14–16.CrossRefGoogle ScholarPubMed
76Wong, IC. Readability of patient information leaflets on anti-epileptic drugs in the UK. Seizure 1999; 8: 35–37.CrossRefGoogle ScholarPubMed
77Carter, TL. Age-related vision changes: a primary care guide. Geriatrics 1994; 49: 37–42.Google ScholarPubMed
78Watson, GR. Assessment and rehabilitation of older adults with low vision. In Halter, JB, Ouslander, JG, Tinetti, ME, Studenski, S, High, KP, Asthana, S (eds). Hazzard's Geriatric Medicine and Gerontology, McGraw-Hill; 2009: 511.Google Scholar
79Krass, I, Svarstad, BL, Bultman, D. Using alternative methodologies for evaluating patient medication leaflets. Patient Educ Couns 2002; 47: 29–35.CrossRefGoogle ScholarPubMed
80Medicines, Medicines and Health Products Regulatory Agency Committee on Safety of Medicines. Always Read the Leaflet. Report of the Committee on Safety of Medicines Working Group on Patient Information. HMSO 2005. Available at: http://www.mhra.gov.uk/home/groups/pl-a/documents/publication/con2018041.pdf. Accessed 1 July 2010.Google Scholar
81European Parliament CotEU. Consolidated Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001 on the Community Code relating to medicinal products for human use as amended by Directive 2002/98/EC, Directive 2004/24/EC and Directive 2004/27/EC. European Commission; 2004.Google Scholar
82Pander, Maat H, Lentz, L. Improving the usability of patient information leaflets. Patient Educ Couns 2010; 80: 113–19.CrossRefGoogle Scholar
83Hirsh, D, Clerehan, R, Staples, M, Osborne, RH, Buchbinder, R. Patient assessment of medication information leaflets and validation of the Evaluative Linguistic Framework (ELF). Patient Educ Couns 2009; 77: 248–54.CrossRefGoogle ScholarPubMed
84Dickinson, D, Raynor, DK, Duman, M. Patient information leaflets for medicines: using consumer testing to determine the most effective design. Patient Educ Couns 2001; 43: 147–59.CrossRefGoogle ScholarPubMed
85Bernier, MJ. Establishing the psychometric properties of a scale for evaluating quality in printed education materials. Patient Educ Couns 1996; 29: 283–99.CrossRefGoogle ScholarPubMed
86Baker, SJ. Who can read consumer product information? Aus J Hospital Pharmacy 1997; 27: 125–31.Google Scholar
87Kirkpatrick, MF, Mohler, BS. Using the readability assessment instrument to evaluate patient medication leaflets. Drug Inf J 1999; 33: 557–63.CrossRefGoogle Scholar
88Chubaty, A, Sadowski, CA, Carrie, AG. Typeface legibility of patient information leaflets intended for community-dwelling seniors. Age Ageing 2009; 38: 441–47.CrossRefGoogle ScholarPubMed
89Voelker, R. Seniors seeking health information need help crossing ‘digital divide’. JAMA 2005; 293: 1310–12.Google ScholarPubMed
90Breemhaar, B, Visser, AP, Kleijnen, JG. Perceptions and behaviour among elderly hospital patients: description and explanation of age differences in satisfaction, knowledge, emotions and behaviour. Soc Sci Med 1990; 31: 1377–85.CrossRefGoogle ScholarPubMed
91Beisecker, AE, Beisecker, TD. Patient information-seeking behaviors when communicating with doctors. Med Care 1990; 28: 19–28.CrossRefGoogle ScholarPubMed
92Blanchard, CG, Labrecque, MS, Ruckdeschel, JC, Blanchard, EB. Information and decision-making preferences of hospitalized adult cancer patients. Soc Sci Med 1988; 27: 1139–45.CrossRefGoogle ScholarPubMed
93Morrow, D, Leirer, V, Sheikh, J. Adherence and medication instructions. Review and recommendations. J Am Geriatr Soc 1988; 36: 1147–60.CrossRefGoogle Scholar
94Shrank, WH, Agnew-Blais, J, Choudhry, NK, Wolf, MS, Kesselheim, AS, Avorn, J, Shekelle, P. The variability and quality of medication container labels. Arch Intern Med 2007; 167: 1760–65.CrossRefGoogle ScholarPubMed
95Murray, MD, Darnell, J, Weinberger, M, Martz, BL. Factors contributing to medication non-compliance in elderly public housing tenants. Drug Intell Clin Pharm 1986; 20: 146–52.Google Scholar
96Wogalter, MS, Vigilante, WJ Jr. Effects of label format on knowledge acquisition and perceived readability by younger and older adults. Ergonomics 2003; 46: 327–44.Google ScholarPubMed
97Anon. One in five cannot read small print on medicine labels. Pharm J 2001; 267: 337.Google Scholar
98Clarity improves safety. Alberta Health Services, 2010 (accessed 1 July 2010; available at: http://www.albertahealthservices.ca/1453.asp).Google Scholar
99Shrank, WH, Gleason, PP, Canning, C, Walters, C, Heaton, AH, Jan, S, Patrick, A, Brookhart, MA, Schneeweiss, S, Solomon, DH, Avorn, J, Choudhry, NK. Can improved prescription medication labeling influence adherence to chronic medications? An evaluation of the Target pharmacy label. J Gen Intern Med 2009; 24: 570–78.CrossRefGoogle ScholarPubMed