Supplementary written information for patients receiving drug therapy: evaluation of readability and efficacy

Clinical Epidemiology - Cabrini

A/Prof Rachelle Buchbinder, A/Prof Stephen Hall, Dr Rosemary Clerehan

This aim of this study was to determine the efficacy of supplementary written information, when provided in addition to verbal explanation, in improving patient knowledge, compliance and early detection of serious adverse effects. The first part of this study is now complete and involved the examination of the readability and content of supplementary written drug information provided by Australian rheumatologists. We found that the average reading age required to comprehend these documents was very high when compared to a published recommendation that health related patient education materials be set at Grade 6 level. In addition, there was a wide variation in the information provided and medical jargon was generally used in preference to lay terminology (see publication below).

Further to this study, a linguistic analysis was performed on the supplementary written patient information sheets describing Methotrexate to determine the systemic functional linguistics of these documents. Systemic functional linguistics views language as a pattern of interlocking systems that can be looked at from the smallest unit (the phoneme) up to the largest (stretches of text or discourse). A linguistic framework has been developed and used to assess these leaflets. The results of this work have now been accepted for publication.

Future work aims to determine the validity and reliability of the linguistic framework and will involve the development of readable, comprehensive patient information letters, for methotrexate, as well as the newer biological agents, and these will be tested in a double-blind randomised controlled trial. The results of this study will provide an understanding of the efficacy of written and verbal information. Findings will be useful in determining directions for evaluating patient education practices of doctors and nurses and in formulating better approaches to patient education

Publications arising from this study so far:

Buchbinder R, Mylvaganam A, Hall S, Grant G, Patrick M. Readability and content of supplementary written drug information utilised by Australian rheumatologists. Med J Aust 2001;174:575-578.

Clerehan R, Buchbinder R, Moodie J. A linguistic framework for assessing the quality of written patient information: its use in assessing methotrexate information for rheumatoid arthritis. Health Educ Res 2005; 20(3):334-44.

Clerehan R, Buchbinder R. Towards a more valid account of functional text quality: the case of the patient information leaflet. Text (accepted Mar 23 2005)