Knowing What to Do: Improve Health Literacy

By M. Jill Odom, PharmD

By now we’ve all heard the staggering statistics on the consequences of medication non-adherence: 125,000 deaths per year and roughly $300 billion annually in direct and indirect health care costs. It has been reported that patients with chronic diseases are, at best, only adherent to their medications about half the time. In the midst of all those facts and figures, it can become easy to tune them out. But a surprising figure, something you probably don’t think about too often, should cause you to pause: according to the most recent national literacy surveys, 11 million Americans are illiterate, possibly due to language barriers or lack of education. Seeing this literacy deficit, it is easy to understand that a quick conversation educating the patient about diabetes or how metformin works is not as straightforward as pharmacists may think.

Many of our patients can follow a direct instruction, such as “take one tablet twice daily,” but their understanding of these words may not be what the pharmacist assumes. Being in health care, it is easy to forget that not everyone knows what “sublingual” or “glucose” means. The solution comes from finding out the best way to communicate with patients in the short amount of time available for counseling. Before you engage in those conversations with patients, it might be helpful to know what information that patients are most interested in, and therefore likely to remember, include drug name, indication, potential benefits followed by potential risks, or adverse effects. Keeping in mind that the current national reading level is that of an eighth grader, pharmacists should be conscious of the terms they use. Additionally, it may be beneficial to have picture representations of common drug or disease mechanisms available for counseling purposes.

Maintain patient preference and privacy at all times, but whenever possible, attempt to include family members or caregivers during counseling. This creates a system of support extending beyond the counseling booth. After counseling a patient, ask them to repeat back to you specific information that you covered to see how they interpreted your instructions. An essential component of empowering our patients to take charge of their personal health care is meeting them on their level. These are some simple steps pharmacists may take to achieve this goal and prevent medication non-adherence.

Reprinted with permission from National Community Pharmacists Association in the March 2012 issue of America’s Pharmacist. For more information about NCPA, visit

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