Low health literacy: Don't assume patient knows own illness, meds

Researchers say this lack of information can be dangerous, but health literacy advocates say not all knowledge is equal.

By Victoria Stagg Elliott, AMNews staff. Sept. 5, 2005.

Wayne Reynolds, DO, a family physician in Newport News, Va., is struggling with what is increasingly being recognized as a national problem. Patients don't know much about the medications they're on.

Dr. Reynolds has signs in his waiting room asking patients to bring in the bottles of all medications they're taking. His nurse reviews the medication history with the patient before he sees them, and then he reviews it again, often discovering that the patient is taking drugs that weren't mentioned the first time through.

If the patient has just been discharged from the hospital, determining medications often can be even more challenging. The patient might not remember what drugs were prescribed. The patient might not bring discharge instructions. The report the hospital sends to him might not arrive until after the first follow-up visit.

"[Patients] tell me they're taking a little white pill. Or they're taking a medication for their diabetes or hypertension, but they don't know the name," Dr. Reynolds said. "I can understand if they don't remember. There's so much going on at discharge. They're packing up, and they want to go home. But it's frustrating."

A study in the August Mayo Clinic Proceedings gives evidence that Dr. Reynolds' problem is common. The study found that of 43 patients discharged from a municipal teaching hospital in New York, only 18 were able to name their diagnosis, 12 were able to list their medications and six were able to name the common side effects of their medications. The authors blame this phenomenon on the time crunch to provide care: Educating the patient on what is going on could be falling by the wayside.