Compliance and effective patient communication
The real lives and languages of patients should inform the design of patient information
By on Sep 21, 2010The real lives and languages of patients should inform the design of patient information
If youre ever been ill on holiday, and found yourself struggling with language barriers in a pharmacy, doctors surgery, or hospital, then youre probably acutely aware of just how important good communication is to managing your health.
Understanding spoken and written communication is crucial for safe and effective treatment.
Much has been written about patient communication over recent years, and most often it focuses on two key issues:
Health literacy: Can patients read and/or process and understand relevant information?
Patient engagement: Do they want to? How motivated are they to play an active role in their own health?
The challenge of health literacy
Health literacy is about more than just reading skills.
A persons literacy, language, and numeracy levels all impact their ability to receive, understand, and process health information.
Theo Raynor, director of LUTO Research, which specializes in user testing of patient materials, defines health literacy as the ability to make sound health decisions in the context of everyday life.
But, for a great many patients, this is still a challenge.
According to the UKs Department of Health, over half of the UKs adult population have literacy skills below Level 2.
This is the level deemed necessary to discuss a condition interactively with a doctor or specialist.
Doctor consultations and patient education materials are often difficult to understand because they use medical terms and healthcare jargon, words that are familiar to health professionals but not to patients.
Its easy to make wrong assumptions about a patients level of familiarity or experience of their condition.
Consider the case of the poor patient who came back from the hospital upset because she felt the doctor had insulted her about her weight problems: He said I was a beast!
She had misunderstood the word obese.
Or the dialysis patient who was given a nutrition advice leaflet outlining foods to avoid, and was then asked if hed understood it.
Yes, I can have fried chicken, he replied, but never poultry.
The only way to tell whether verbal or written communication can be understood by the people who need to understand it is to user-test it.
The benefits of user testing
User testing of product leaflets is now mandatory in some countries, and has become highly encouraged across Europe in recent years.
However, for user testing to be effective, its important that it is performance-based testing based not just on what leaflets contain but on whether information can be found and understood.
In practice, this usually involves identifying whether a number of key points have been taken on board by the patient.
User testing shouldnt be restricted to mandatory documents such as patient information leaflets either; it has a role to play across all patient-facing communications.
Making patient materials or websites easy to read and understand is just the first part of the overall task, however.
How can we engage with patients so that they are motivated and actively want to manage their own health?
Here the old adage, Its not (just) what you say, but the way that you say it... is certainly true.
We need to look at groups of patients and try to understand them in the context of their everyday livestheir interests, their hobbies, their values.
What do they read? What do they watch on TV? Which websites do they regularly visit?
We then need to take a critical look at the information we give patients and ask: Is it as accessible, interesting, and engaging as their favourite magazine or website?
The life and language of patients
We can learn a lot about the language patients may use from patient support groups discussions, or website forums such as www.patientslikeme.com.
They probably wont talk about medication or injections, but they will talk about pills and shots.
Theyll freely admit to doing things that theyd never tell their doctor, like pill-cutting and skipping doses.
This insight into the life and language of our patients should inform the design and development of all future patient communication and information.
Its an approach the UKs Mens Health Forum took when they first published the now legendary Haynes Man Manual back in 2003.
Written in the format of the iconic Haynes car manuals, the style is practical, down-to-earth, and funny.
By linking with the Haynes brand, it was immediately appealing and relevant to the hard-to-reach male target audience.
In the highly academic and sometimes worthy world of pharma, its often difficult to view our communications from a patient perspective.
And sometimes legal and regulatory constraints stop us from being as creative as wed like.
But, ultimately, we must aim for the most effective, patient-friendly approach.
After all, as Seth Godin said about blogging, If no one reads it, does it exist?
Di Stafford is Director of The Patient Practice, a health-marketing consultancy. She specializes in health communication, patient compliance, and health-related behavior change.
For more on effective communication with patients, see Improving adherence by listening and learning and Compliance: Speaking the patient's language