Are Doctors To Blame?

Tuesday, May 27, 2008

Health officials have long lamented the gaps in literacy that plague many patients, particularly the poor or poorly educated. Study after study has found that the inability to read or understand basic terms, such as "elevate" or "take on an empty stomach," places patients at high risk for complications and rehospitalization.

Now a study in the May issue of the journal Mayo Clinic Proceedings suggests that low levels of functional health literacy might also reflect inadequate instructions by physicians at the time patients are discharged.

A team led by internist Michael Maniaci at the Mayo Clinic in Jacksonville, Fla., surveyed 172 patients discharged between February and April 2006 who were sent home with at least one new medicine. Between four and 18 days after leaving, researchers called and asked them if they knew the name of the medicine they had been told to take, as well as the proper amount, dosing schedule and potential side effects.

Overall, 86 percent said they knew they had been given a new drug, but only 64 percent could state its name or purpose. And only 11 percent reported that they had been told of potential adverse effects. Older patients tended to answer fewer questions correctly than younger patients. But there was no difference between those with more formal education and those with less schooling.

Researchers say the latter finding suggests that poor communication by physicians, and not merely low levels of health literacy, might be to blame.

"The communication skills of health care professionals must be assessed," Maniaci and his colleagues write, adding that hospitals must develop tools to reduce the risk to patients, in addition to simplifying discharge instructions.

-- Sandra G. Boodman

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