Study Reveals Challenges in Health Literacy of Patients

This transcript has been edited for clarity. 
Hello. I’m Dr Maurie Markman, from City of Hope. I’d like to briefly present a very interesting paper, and one that, as clinicians and certainly as researchers, we need to take very seriously in terms of the broader implications beyond what the researchers in this study reported.
The paper is “Readability of Patient Education Materials in Head and Neck Cancer: A Systematic Review,” published in JAMA Otolaryngology–Head & Neck Surgery earlier this year. 
These researchers analyzed literature that looked at a question in two parts; the first included the population of head and neck cancer patients, and the term they used was “health literacy.” They were looking at a variety of formats to define health literacy. They identified inadequate or suboptimal health literacy in anywhere from 12% to 47% of the patients, meaning, how much they know about head and neck cancer. I should note that, for the health literacy question, there were eight studies reported on this topic.
The second part of this survey was an analysis of the readability of the material that had been prepared for patients to explain treatment, the disease, prognosis, and so on. In fact, 17 studies have been published on the topic.
In the readability material, they noted that the mean grade level — and there are objective criteria where researchers in this area have said what educational level we are at in terms of the material — was 8.8 to 14.8. We’re obviously talking about junior high level all the way up to college level. That was the mean level of this material. 
It should be noted, and this has been stated many times, that the American Medical Association has recommended that the grade level for this material be at grade 6 or lower, and the mean level is not even close to that in this material. That is consistent with some of these health literacy questions. 
Here, we have evidence in this patient population, and there are data published in the literature. I’m not going to comment on or challenge the metrics that are used, but one third of patients have some issues with understanding what’s going on relative to the disease. 
We should pause and think about who is preparing this educational material at what level, and make sure that we are providing the information that is essential for our patients to understand the disease, prognosis, and possible treatment options, particularly when there are so many options and decisions that patients have to make.
Patients and their families need to be informed. They need to be actively involved in the decision-making process. If the material we’re preparing for them and their families to look at is somehow not interpretable, we need to think about how to do a better job. Thank you for your attention.