Health Literacy in Medicines Use and Pharmacy

A Definitive Guide

1st Edition - November 27, 2024
Imprint: Academic Press
Editors: Ahmed Awaisu, Emad Eldin Munsour, Parisa Aslani, Rabia Hussain, Zaheer-Ud-Din Babar
Language: English
Paperback ISBN:
9 7 8 - 0 - 1 2 - 8 2 4 4 0 7 - 4
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 8 5 9 7 1 - 4

Health Literacy in Medicines Use and Pharmacy: A Definitive Guide highlights issues related to medication literacy from the context of the pharmacist and other healthcare professio… Read more

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Health Literacy in Medicines Use and Pharmacy: A Definitive Guide highlights issues related to medication literacy from the context of the pharmacist and other healthcare professionals. This definitive guide will undoubtedly serve as an invaluable resource for healthcare professionals in training and practice, fostering excellence in patient care globally. The book provides a clear explanation of medication literacy, presents different tools to assess health and medication literacy, readability, and comprehensibility of written medicine information (WMI), and elaborates on different approaches to develop customized and patient-friendly WMI. The book also covers health and medication literacy in special populations, including geriatrics, pediatrics, and pregnant/lactating patients. Written by experts in health communication, this book will help pharmacists, other health professionals, educators, students, and regulators, who need to develop customized educational materials that can be understood by a broad range of patients, especially those with low health literacy.

Health Literacy in Medicines Use and Pharmacy
Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Authors biography
Foreword
Preface
Chapter 1 Introduction to health and medication literacy
Abstract
Keywords
1 Introduction to health communication
1.1 Health communication and patient empowerment
1.2 Health communication as a competency for healthcare professionals
1.3 Role of health communication in health and medication literacy
2 Defining health literacy concept
2.1 Definition of health literacy
2.2 Historical evolution of health literacy
2.3 Current perspectives on health literacy
2.4 Aspects of health literacy
3 Defining medication literacy
3.1 Definition of medication literacy
3.2 Association between health literacy and medication literacy
3.3 Aspects of medication literacy
3.4 Other concepts related to medication literacy
4 Challenges and barriers to achieving health and medication literacy
5 Role of health care professionals in promoting health and medication literacy
5.1 Pharmacist’s contribution to health and medication literacy
5.2 Collaborative approach in the delivery of health and medication literacy
6 Lessons learned and conclusion
References
Chapter 2 The importance of health and medication literacy
Abstract
Keywords
1 Introduction
1.1 Overview of health and medication literacy
1.2 Why this chapter?
2 Why health and medication literacy are important?
2.1 The importance of health and medication literacy
2.2 Covariates and determinants associated with poor health and medication literacy
3 Lessons learned and the way forward
4 Conclusions
References
Chapter 3 The impact of health and medication literacy on health outcomes
Abstract
Keywords
1 Introduction
2 Measuring medication literacy: How does this compare to health literacy measures?
3 Sociodemographic factors associated with medication literacy: Who is at risk of suboptimal medication literacy?
4 Health and/or medication literacy and health-related outcomes
4.1 Health-related outcomes of interest relating to medication literacy
4.2 Understanding and actioning medicine information
4.3 Impact on medication self-management and medication adherence
4.4 Health and/or medication literacy, treatment decision making and communication
4.5 Health status/health-related quality of life, healthcare service utilization and mortality
5 Strategies to improve health and/or medication literacy and outcomes
5.1 The role of pharmacy in improving medication literacy and health-related outcomes
6 Conclusion
References
Chapter 4 Assessment of health and medication literacy
Abstract
Keywords
1 Health literacy assessment instruments
1.1 Introduction to health literacy assessment
1.2 Characteristics of healthy literacy assessment instruments
1.3 Generic health literacy assessment instruments
1.4 Disease-specific health literacy assessment instruments
2 Medication literacy assessment instruments
2.1 Introduction to medication literacy assessment
2.2 Common medication literacy assessment instruments
3 Considerations for diverse populations
3.1 Pediatric population
3.2 Geriatric population
3.3 People with some mental or intellectual health problems
4 Considerations for effective health and medication literacy assessment
4.1 Individualizing the assessment
4.2 Dealing with language barriers during the assessment
4.3 Practice, training, and work environment
5 Future trends in health and medication literacy assessment
6 Ethical considerations in health and medication literacy assessment
6.1 Autonomy, informed consent, privacy, and confidentiality
6.2 Beneficence and non-maleficence
6.3 Justice, equity, and cultural competency
7 Lessons learned and conclusion
References
Chapter 5 Evidence-based interventions for improving health and medication literacy in community and healthcare settings
Abstract
Keywords
1 Introduction
2 Approaches to improving health and medication literacy
2.1 Written health information
2.2 Web-based health information
2.3 Low health literacy initiatives
2.4 Targeted mass media campaigns
3 Conclusions
References
Chapter 6 Developing written health and medicine information
Abstract
Keywords
1 Introduction
2 Planning stage
2.1 Defining the audience
2.2 Setting a purpose
3 Development stage
3.1 Content
3.2 Plain language
3.3 Active voice
3.4 Personal pronoun usage
3.5 Inclusive language
3.6 Headings
3.7 Length
3.8 Numerical representation
3.9 Font size and style
3.10 White space
3.11 Design layout
4 Evaluation stage
4.1 Patient education material assessment tool
4.2 The CDC clear communication index
4.3 Suitability assessment of materials
4.4 Readability formulas
4.5 Patient feedback
5 Conclusion
References
Chapter 7 Pharmaceutical pictograms in supporting health literacy
Abstract
Keywords
1 Introduction to health communication, health literacy, and applications of pictograms in healthcare
1.1 Health communication, health literacy and patient empowerment
1.2 Objectives of the chapter
1.3 Introduction to pictograms and their application in healthcare
2 Pictogram design, modification, evaluation and validation
2.1 Employing best practice pictogram design principles
2.2 Pictogram databases and international pictogram acceptability standards
2.3 Pictogram design guidelines and associated literature resources
2.4 Methods for pictogram comprehension testing and validation
2.5 Misinterpretation of pictograms
3 Pictogram comprehension – Sociodemographic and other influencing factors
3.1 Sociodemographic factors influencing pictogram comprehension
3.2 Health literacy as a factor influencing pictogram comprehension
4 The impact of pictograms on health outcomes
4.1 Patient education, knowledge comprehension/improvement, recall
4.2 Self-efficacy and adherence to medications
4.3 Patient preference, satisfaction or preferred format for information
4.4 Health literacy as an outcome
5 Health literacy and pictogram intervention studies
6 Summary, future research and conclusions
References
Chapter 8 Enhancing health literacy through user testing: Iterative design for plain language and plain interaction
Abstract
Keywords
1 Introduction
2 Cognitive load and health literacy
3 User testing and plain language
4 User testing and plain interaction
5 User testing methods for patient materials
6 Logistics for user testing when participants have low health literacy
7 Conclusion
References
Chapter 9 Readability formulae: Guiding the development of health and medicine information
Abstract
Keywords
1 Introduction
1.1 Clear communication in healthcare
1.2 Readability of written health information
1.3 Historical overview of readability formulae
2 Readability formulae in health communication
2.1 Flesch readability formulae
2.2 SMOG grading
2.3 Gunning-Fog Index
2.4 Dale-Chall readability formula
2.5 Graphical representation of readability
2.6 Sophisticated readability formulae
3 Criticisms and ethical considerations in readability assessment
3.1 Common criticisms of readability formulae
3.2 Universal applicability of readability metrics
3.3 Addressing challenges and ethical considerations
4 Readability metrics in patient education materials
4.1 Importance of written medicine information
4.2 Developing patient education materials: Patient brochures and pamphlets
4.3 Readability considerations in informed consent forms
4.4 Readability of online health information
4.5 Addressing comprehension challenges in health information material
4.6 Successful implementation of readability formulae
5 Future directions and innovations
5.1 Integration of readability metrics with emerging technologies
5.2 Incorporating several factors in readability assessment
5.3 Accessibility considerations
5.4 Cross-linguistic readability assessment
5.5 Multimodal readability assessment
5.6 Challenges and opportunities in the evolving landscape
6 Lessons learned and conclusion
References
Chapter 10 Strategies for communication across health literacy levels in pharmacy settings
Abstract
Keywords
1 Introduction
2 Awareness of health literacy in pharmacy settings
2.1 Perceptions of health literacy in the pharmacy
2.2 Assessing health literacy in pharmacy settings
3 Verbal communication strategies
3.1 Teach back method
3.2 Teach to goal method
3.3 Chunk and check technique
3.4 Ask Me 3/Teach Me 3
4 Visual and medication label communication strategies
4.1 Validated pharmaceutical pictograms
4.2 Prescription medication labels
5 Lessons learned and conclusions
References
Chapter 11 Health and medication literacy in children and their caregivers
Abstract
Keywords
1 Introduction
1.1 Medication use in the pediatric population
1.2 The impact of health literacy on children’ health outcomes
2 Health and medication literacy issues in children and their caregivers
2.1 Safety of medicines
2.2 Management of chronic diseases
2.3 Caregivers’ management of acute illness
3 The implications of low health and medication literacy
3.1 Dosing and administration problems
3.2 Poor medication adherence
4 Measurement of health literacy in children
5 Healthcare providers and home medication errors
6 Strategies and interventions to improve health and medication literacy in children
7 Role of technology in improving medication literacy
8 Health and medication literacy in migrants and refugees
9 Conclusion
References
Chapter 12 Health and medication literacy in older adults
Abstract
Keywords
1 Introduction
2 Impact of health literacy on health outcomes
3 Health literacy assessment tools for older adults
4 Factors affecting health literacy in older adults
5 E-health (digital health) literacy and older adults
6 Interventions to promote health literacy in older adults
7 Healthcare team roles in promoting health literacy in older adults
7.1 Pharmacist’s role
7.2 Nurse’s role
7.3 Physician’s role
8 Conclusion
References
Chapter 13 Health and medication literacy during pregnancy and breastfeeding
Abstract
Keywords
1 Introduction
1.1 Levels of health literacy in general populations
1.2 Health literacy levels in women of reproductive age
1.3 Objectives of the chapter
2 Defining maternal health literacy
2.1 Health literacy—risk versus asset
2.2 Maternal health literacy levels
3 Why is improving maternal health literacy important?
4 Health and medication literacy during pregnancy and breastfeeding
5 Maternal health literacy interventions
5.1 What do existing reviews tell us?
5.2 Additional and emerging research in maternal health and medication literacy
5.3 Skills-based interventions for new parents
5.4 Digital interventions
6 Conclusion and future directions
References
Chapter 14 Health literacy in complementary and alternative medicine
Abstract
Keywords
1 Introduction
2 Defining and measuring health literacy in complementary and alternative medicines
2.1 Health literacy in complementary and alternative medicine
2.2 Available tools for assessing CAM-related health literacy
3 Healthcare outcomes related to CAM health literacy
3.1 CAM-related contamination
3.2 CAM interactions with orthodox medicines
3.3 Toxicities related to CAM use
3.4 CAM-related adverse drug reactions
3.5 Potential misuse and abuse of CAM
3.6 Medication non-adherence due to preference for CAM use
3.7 Facilitators of CAM-related adverse events in clinical practice settings
4 Evidence-based strategies for improving CAM health literacy among CAM users
4.1 Complementary medicine education and outcomes (CAMEO) program
4.2 Bee SAFE intervention program
4.3 CM education intervention (interventions to improve decision self-efficacy)
5 Conclusion
References
Chapter 15 The use of information and digital health technologies in medication literacy
Abstract
Keywords
1 Introduction to digital health and key concepts
1.1 Background
1.2 Learning objectives
1.3 What is digital health?
1.4 Applications and benefits of digital health technologies
1.5 The role of digital health in strengthening healthcare systems
1.6 Medication literacy
1.7 Digital health literacy
2 Applications of digital health to medication literacy
2.1 Institutional level
2.2 Individual level
3 Policies and regulations to protect patients’ data
3.1 Legislative framework
3.2 Opt out of electronic patient records
4 Resources for developing digital health medication literacy content or applications
5 Lessons learned and conclusion
References
Chapter 16 Advancing pharmacy research on health literacy
Abstract
Keywords
1 Introduction
2 Prevalence and outcomes of functional health literacy
2.1 Measuring functional health literacy
2.2 Prevalence of low functional health literacy
2.3 Impact of functional health literacy
3 Functional health literacy research related to pharmacy
3.1 Label comprehension
3.2 Functional health literacy and nonprescription medications
3.3 Counseling interventions and functional health literacy
3.4 Training student pharmacists
4 Future research considerations
4.1 Research efforts should expand to address functional health literacy at the community and societal levels
4.2 Research efforts in functional health literacy should be representative of diverse patient populations and seek to address health inequity
4.3 Research efforts in functional health literacy should implement translational science principles to change practice
5 Conclusion
References
Chapter 17 Advancing health literacy through interprofessional education: Strategies for collaborative learning and practice
Abstract
Keywords
1 Introduction
2 Moving from individual-based health literacy into an organizational approach
3 Rationale for an interprofessional collaborative approach to health literacy in practice
4 Interprofessional education and learning from, with, and about each other for health literacy
4.1 Campus-based core IPE learning activity: Understanding patient/client partnerships in a team context
4.2 Practice-based core IPE learning activity: IPE component in a clinical placement
4.3 Practice-based elective IPE learning activity: Health literacy—Enabling effective interprofessional communication with patients and families for safe, quality care
5 Advancing an organizational culture of interprofessional health literacy
5.1 Putting interprofessional health literacy into practice at University Health Network
5.2 Fostering interprofessional collaboration for health literate care organizational initiatives
5.3 Organizational resources for clinical and staff education in interprofessional health literacy
6 Conclusion
References
Chapter 18 Developing and incorporating health and medication literacy content in pharmacy curriculum
Abstract
Keywords
1 Introduction to health and medication literacy in health profession education curricula
2 Current status of health and medication literacy in pharmacy curriculum
3 Integrating health and medication literacy and proposed modules in pharmacy curricula
3.1 Pedagogical approaches to integrating health and medication literacy in pharmacy curriculum
3.2 Proposed modules on health and medication literacy in pharmacy curriculum
3.3 Agency for Healthcare Research and Quality’s modules on pharmacy health literacy practices
4 Important resources for developing pharmacy health literacy curriculum
5 Lessons learned and conclusion
References
Chapter 19 Global initiatives for improving health and medication literacy
Abstract
Keywords
1 Introduction
2 Global initiatives to improve health and medication literacy
2.1 Training of healthcare providers
2.2 Health policy and insurance coverage
2.3 Digital health development and application
2.4 Targeted population interventions
3 Impact of global initiatives on health and medication literacy
3.1 Shared decision-making
3.2 Data gaps in low-resource settings
3.3 Cultural competencies
3.4 Social capital development
4 Lessons learned for future development
5 Conclusion
References
Chapter 20 Understanding the concepts of health literacy in the context of medication safety
Abstract
Keywords
1 Introduction
1.1 Patient safety
1.2 The World Health Organization global patient safety initiatives
1.3 The international pharmaceutical federation patient safety initiatives
2 Health literacy
2.1 Defining health literacy and its impact on patient safety
2.2 Understanding information on patient information leaflets
2.3 Understanding medication labels
2.4 Medication knowledge and communication
2.5 Impact of limited health literacy on medication use and safety
2.6 Focus on special populations
3 Evidence-based strategies and interventions addressing medication safety issues in the context of health and medication literacy
4 Medication-related responsibilities and patient safety
4.1 Access to medication
4.2 Supply medication information
4.3 Medication appropriateness
4.4 Medication management
4.5 Assess health status
5 Recommendations for improving patient safety through health literacy interventions
5.1 Verbal communication
5.2 Health education
5.3 Health literacy assessment
5.4 Rewards and incentives
5.5 Patient-friendly office procedures
5.6 Target health literacy broadly
5.7 Expert patient program
5.8 Following-up with patients
6 Conclusion
References
Index

Ahmed Awaisu

Prof. Ahmed Awaisu is a Professor of Clinical Pharmacy & Practice. He is currently the Head of the Department of Clinical Pharmacy and Practice in the College of Pharmacy at Qatar University. His research interest includes outcome-based research, pharmacoepidemiology and medication safety, pharmacy education, and health promotion. Prof. Awaisu has established a medication use optimization research niche using generous funds from Qatar University, Qatar National Research Fund, Hamad Medical Corporation, and other agencies. He has been involved in mentoring PhD, MSc, and undergraduate research projects related to prescribing/deprescribing, medication adherence, medication safety, quality of life, and other health-related outcomes.

Prof. Ahmed Awaisu was the former Associate Editor of Value in Health Regional Issue (CEWAA). He was also the Section Editor (Clinical Pharmacy) for the Elsevier-published textbook entitled “Encyclopedia of Pharmacy Practice and Clinical Pharmacy”. He was also the former Chair of the Qatar University Institutional Review Board.

Prof. Awaisu was the recipient of the “Qatar University Merit Award for Outstanding Faculty” in September 2017 and the “Qatar University Research Excellence Award in Medical, Biomedical and Health Sciences” in April 2019. He was also the recipient of the “Best New Investigator Award” by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) during the 14th Annual ISPOR European Conference in Madrid, Spain in November 2011. He has served as the WHO Lead Consultant for reviewing the health system development in some countries. He is a member of the American College of Clinical Pharmacy (ACCP), and the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), among others.

The scholar is a very passionate and outstanding scholar whose vision is to make sustainable impact in the society through grooming competent healthcare professionals, mentoring novice researchers, high-impact innovative research, and advancing healthcare.

Affiliations and expertise

Department of Clinical Pharmacy & Practice, College of Pharmacy, QU Health Sector, Qatar University, Doha, Qatar

Emad Eldin Munsour

Dr. Emad Eldin Munsour holds a PhD degree in Pharmacy Practice from Universiti Sains Malaysia and has around 21 years in Pharma-regulatory and compliance area. He looks after the authorization of pharmaceutical products, including evaluation of bioequivalence studies, clinical trials, and Pharmacovigilance system, in addition to CMC (Chemistry, Manufacturing, and Controls). Dr. Emad is the editor of Qatar National Formulary (QNF) and is a professional reviewer for the WHO bulletin and Value in Health Regional issues. He is also involved in many projects related to Qatar National Health Strategy (NHS), including, the National Drug Coding, Generic use and advancement of the pharmaceutical legislative framework. He participated in the activities of National Pharmacovigilance Center (Associate Member of Uppsala Monitoring Center, WHO).

Dr. Emad is currently leading the national pharmaceutical track and trace project in Qatar and actively engaged in GS1 implementation in the healthcare sector; he is also engaged in the development and implementation of national medicines security strategy. Emad is a member of the working group for the establishment of policies and mandates for regulating national pharmaceuticals related Digital Health/e-Health data and interoperability standards.

His research interest in the area of health and medication literacy, drug and poisons information services quality of life and patient reported outcome; he shared his research in various international conferences and published several articles on pharmaceutical care and other pharmacy practice areas.

Affiliations and expertise

Section Head, Pharmacy and Drug Control Department, Ministry of Public Health, Doha, Qatar.

Parisa Aslani

Prof. Parisa Aslani, PhD, BPharm (Hons), MSc, G Cert Ed Stud (Higher Ed), is a Professor in Medicines Use Optimisation at The University of Sydney School of Pharmacy. Parisa has been a researcher and educator in the field of consumer medicine information and adherence for nearly 30 years. Her areas of research interest include health and medicines information, health literacy, medication adherence and cognitive pharmaceutical services.

Prof. Aslani is currently the Deputy Head of School and Director of Academic Career Development at the School of Pharmacy, The University of Sydney. She is a fellow of the International Pharmaceutical Federation (FIP), currently a FIP Vice President, and Immediate Past President of the Health and Medicines Information Section. Prof. Aslani was the Chair of the 81st FIP World Pharmacy and Pharmaceutical Sciences Congress 2023 held in Brisbane, Australia. She is also a Fellow of the Pharmaceutical Society of Australia, and a Foundation Fellow of the Australian and New Zealand College of Advanced Pharmacy.

Affiliations and expertise

School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia

Rabia Hussain

Dr. Rabia Hussain is a Senior Lecturer at the School of Pharmaceutical Sciences, Universiti Sains Malaysia, located in Penang. She is a renowned researcher in the field of medicine safety, pharmacovigilance, medication adherence, and clinical pharmacy. Her research has been published in high-impact journals and focuses on pharmacovigilance, research methods in pharmacy practice, clinical pharmacy, and issues related to medicines use.

Dr. Hussain has collaborated with ReAct - Action on Antibiotic Resistance and Health Action International, Asia Pacific, to improve the use of antibiotics. She is the Section Editor for the Journal of Pharmaceutical Policy and Practice (JoPPP) and has edited "Encyclopaedia of Evidence in Pharmaceutical Public Health and Health Services Research in Pharmacy (Elsevier)". Dr. Hussain is a fellow of the Royal Society for Public Health, and she has been nominated as the Apex Young Scholar by Universiti Sains Malaysia.

Affiliations and expertise

Discipline of Social & Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia

Zaheer-Ud-Din Babar

With over 25 years of experience in pharmaceutical policy and practice research, Prof Zaheer Babar is a global authority and a prolific author in this field. He comes with a long-standing academic career in pharmacy in New Zealand, and the United Kingdom. He is globally known for his work in policy and practice, including quality use of medicines, and issues related to medicines access and pricing.

Prof. Babar has published over 300 papers and is considered the leading researcher in the “pharmacy practice research category”. He has published in high-impact journals such as PLoS Medicine and the Lancet and has acted as a consultant for the WHO, RPS, UNDP, HAI, MSH, FIP, International Union Against Tuberculosis and Lung Disease, World Bank, European Union, and the Pharmaceutical Management Agency of New Zealand. His edited work includes "Economic Evaluation of Pharmacy Services", "Pharmaceutical Prices in the 21st Century", "Pharmaceutical Policies in Countries with Developing Healthcare Systems", "Global Pharmaceutical Policy", "Access to high-cost medicines", "Pharmacy Practice Research Methods", "Pharmacy Practice Research Case Studies" , "Encyclopaedia of Pharmacy Practice and Clinical Pharmacy", and "Encyclopaedia of Evidence in Pharmaceutical Public Health and Health Services Research in Pharmacy". Published by Elsevier and Adis/Springer, his work is used in curriculum design, policy development, and referral all around the globe. Professor Babar is the founding Editor-In-Chief of the Journal of Pharmaceutical Policy and Practice [IF = 4.2], a high-impact publication that provides evidence-based insights and recommendations for policymakers, practitioners, and researchers. He can be contacted at: [email protected]

Affiliations and expertise

Professor of Clinical Pharmacy and Practice College of Pharmacy, Qatar University, Qatar

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Health Literacy in Medicines Use and Pharmacy

A Definitive Guide

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World Book Day Celebration!

Institutional subscription on ScienceDirect

Ahmed Awaisu

Emad Eldin Munsour

Parisa Aslani

Rabia Hussain

Zaheer-Ud-Din Babar

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