Study: Doctors should tailor communications to match patients' health literacy

Study: Doctors should tailor communications to match patients' health literacy
By using simple language, doctors can help overcome low health literacy among some patients, a new study suggests. File photo by Andrei Rahalski/Shutterstock

Dec. 17 (UPI) -- Physicians should tailor their language to match each patient's individual health literacy level to best communicate healthcare information, a study published Friday by Science Advances found.

When physicians use simple language to explain health problems and symptom management, they foster better understanding among patients with varying literacy levels, data from the analysis of more than 230,000 email exchanges between physicians and diabetes patients showed.


The method that performed better in the study, "universal tailoring," sees doctors customize the complexity of their messaging based on what the patient's health literacy level.

This is opposed to the less successful method of "universal precautions," where doctors always simplify their language in the same way.

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"There is perhaps no more universal healthcare experience than being sick and not understanding one's doctor," study co-author Dr. Dean Schillinger told UPI in an email.

"Not only is this a frustratingly common, and often dangerous, experience, but it's also a massive and costly public health problem," said Schillinger, a health communications specialist and professor of medicine at the University of California-San Francisco.


An estimated 80 million adults in the United States have limited or low health literacy, or ability to obtain, read, understand and use healthcare information to make appropriate care decisions and follow directions for treatment, research suggests.

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Low health literacy has been linked with low overall health, failure to adhere to treatment and worse prognoses when faced with serious or life-threatening conditions, according to the federal Office of Disease Prevention and Health Promotion.

For this study, Schillinger and his colleagues assessed how well the complexity of language used by physicians matched patient health literacy levels by analyzing email exchanges between 1,094 physicians and 4,331 ethnically diverse, English-speaking patients with diabetes.

About 475, or 11%, of the patients reported "poor" understanding of their healthcare provider, including 14% of those who had low health literacy, the data showed.

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Of the patients, 47% had evidence of "discordance" -- or different levels of language complexity or sophistication -- in their email exchanges with physicians.

Among the 1,560 patients classified as having low health literacy in the study, 53% had evidence of "discordance" in their email exchanges with physicians.

For patients with lower health literacy, those with discordant physician communications were more than 39% likely to report poor understanding of their physician, according to the researchers.


"We discovered that most doctors use language that is too complex for their patients to understand, but we also discovered that some doctors tailor their language in ways that overcome the confusion that is so common in healthcare," Schillinger said.

"Physicians' skill in matching their language to that of their patients -- what we call precision communication -- appears to be useful for all patients, but is especially helpful for the one in three Americans who have low health literacy," he said.

The findings suggest that doctors can and should adjust how they interact with patients -- both in how they listen to questions and respond -- to achieve precision communication, according to Schillinger.

In addition, patients who are confused by something their physicians say should ask their doctor to adjust their explanations, advice or instructions to meet their communication needs, he said.

"Our research has shown that, for the most part, those patients who need the most communication and stand to gain the most from it, like those with limited health literacy or limited English proficiency, tend to receive the least communication," Schillinger said.

"And when they do receive it, it tends not to be the kind of precision communication that we have shown is most helpful," he said.


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