Reading Difficulty of Consumer Medicine Information (CMI) Leaflets for Five Chronic Ailments in Ghana
DOI:
https://doi.org/10.26437/ajar.v10i1.684Keywords:
Chronic diseases. communication. health literacy. patient. readabilityAbstract
Purpose: This study examined the reading difficulty of Consumer Medicine Information leaflets of five chronic-disease medicines.
Design/ Methodology/ Approach: In this descriptive, cross-sectional study, 192 leaflets were randomly downloaded from the World Wide Web: Asthma (35), Cancer (42), Diabetes (41), HIV (29), and Hypertension (45). Text from each ‘leaflet’ was analysed using the Simple Measure of Gobbledygook (SMOG), Flesch Reading Ease, and Gunning Fog indexes.
Findings: Consistently, the difficulty of the texts exceeded the recommended difficulty levels. A comparison of mean scores showed leaflets for HIV medication were the most difficult to read because they were written at grade levels too high for the average literate adult.
Research Limitations: Readability indexes are suited to only prose. They neither measure how well-organised the text is, nor indicate the suitability of typographical features, such as illustrations, typeface, appeal of presentation, and use of white space. Readability scores do not account for readers’ backgrounds, exposure, and motivation.
Practical implication: Developing user-friendly consumer medicine information leaflets can reduce the need for extensive explanations, allowing healthcare providers to allocate their time more efficiently.
Social Implication: Improving the readability of Consumer Medicine Information leaflets can enhance health literacy, leading to better health outcomes and reduced healthcare costs associated with medication errors.
Originality/Value: While readability indices have been widely used, their application specifically to Consumer Medicine Information leaflets for chronic ailments such as diabetes, hypertension, asthma, arthritis, and heart disease in Ghana is novel. Chronic ailments require continuous and often complex medication regimens, making readability particularly crucial.
References
Alotaibi, S., Alyahya, M., Al-Khalifa, H., Alageel, S., & Abanmy, N. (2016). Readability of Arabic
Medicine Information Leaflets: A machine learning approach. Procedia Computer Science, 82, 122–126. https://doi.org/10.1016/j.procs.2016.04.017
American Medical Association (2005) Understanding health literacy: Implications for medicine
and public health. Chicago, IL: AMA Press.
Audit Commission (1993). Communication with Patients: audit guide. London, UK: Audit
Commission.
Berkman, N. D., Davis, T. C. & McCormack, L. (2010). Health literacy: What is it? Journal of
Health Communication, 15(SUPPL. 2), pp. 9–19. doi: 10.1080/10810730.2010.499985.
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd edn). New York:
Lawrence Erlbaum Associates.
Coulter, A., & Ellins, J. (2007). Effectiveness of strategies for informing, educating, and involving
patients. British Medical Journal, 335(24), 24–27. https://doi.org/10.1136/bmj.39246.581169.80
Cramer, D., & Howitt, D. (2004) The SAGE Dictionary of Statistics (Volumes 1-10). London, UK:
Sage Publications. https://doi.org/10.4135/9780857020123
Cutilli, C. C. & Bennett, I. M. (2009). Understanding the Health Literacy of America.
Orthopaedic Nursing, 28(1), 27–32. doi: 10.1097/01.NOR.0000345852.22122.d6
Cutts, M. (2013) Oxford Guide to Plain English (4th edn). Oxford, England: Oxford University
Press.
Ellis, P. D. (2010). The Essential Guide to Effect Sizes: Statistical power, meta-analysis, and the
interpretation of research results. Cambridge, UK: Cambridge University Press.
Fekadu, G., Bekele, F., Tolossa, T., Fetensa, G., Turi, E., Getachew, M., ... & Labata, B. G. (2021).
Impact of COVID-19 pandemic on chronic diseases care follow-up and current perspectives in low resource settings: a narrative review. International journal of physiology, pathophysiology and pharmacology, 13(3), 86.
Flinton, D., Singh, M. K., & Haria, K. (2018). Readability of internet-based patient information
for radiotherapy patients. Journal of Radiotherapy in Practice, 17(2), 142–150. https://doi.org/10.1017/S1460396917000620
Furlan, G., & Power, D. (2020). The unintended consequences of adverse event information on
medicines’ risks and label content. Pharmaceutical Medicine, 34(6), 369-380.
Georgsson, S., & Carlsson, T. (2020). Readability of web-based sources about induced abortion:
a cross-sectional study. BMC Medical Informatics and Decision Making, 20, 1-8.
Gyasi, W. K. (2013). Readability and Health Communication: An analysis of the readability of
commonly used Malaria drugs information leaflets in Cape Coast, Ghana’. IOSR Journal of Research & Method in Education (IOSRJRME), 2(4), 17–25. https://doi.org/10.9790/7388-0241725
IBM (2020, April 16). Does SPSS offer Tukey-Kramer post-hoc tests? Retrieved May 13, 2020
from https://www-01.ibm.com/support/docview.wss?uid=swg21478616.
Im, H., & Huh, J. (2022). Effects of conflicting prescription drug information from direct-to-
consumer advertising and drug injury advertising on patients’ beliefs and medication adherence. Research in Social and Administrative Pharmacy, 18(7), 3119-3130.
Institute of Medicine (2011). Promoting health literacy to encourage prevention and wellness: A
workshop summary. Washington, DC: The National Academies Press.
Institute of Medicine, Board on Neuroscience and Behavioural Health & Committee on Health
Literacy (2004). Health Literacy: A prescription to end confusion (Nielsen-Bohlman, L., Panzer, A. M., & Kindig, D. A., Eds.). Washington, DC: The National Academies Press. https://cutt.ly/3cFvNdT
Leuck, S. (2016, November 7). A Brief History of Consumer Medication Information, Pharmacy
Times. Retrieved April 18, 2019 from https://www.pharmacytimes.com/contributor/steve-leuck-pharmd/2016/11/a-brief-history-of-consumer-medication-information
Mancuso, J. M. (2008). Health literacy: A concept/dimensional analysis. Nursing and Health
Sciences, 10(3), pp. 248–255. doi: 10.1111/j.1442-2018.2008.00394.x.
McCarthy, C. J., Berkowitz, S., Ramalingam, V., & Ahmed, M. (2023). Evaluation of an artificial
intelligence chatbot for delivery of IR patient education material: a comparison with societal website content. Journal of Vascular and Interventional Radiology, 34(10), 1760-1768.
Monkman, H., Kushniruk, A. W., Borycki, E. M., Sheets, D. J., & Barnett, J. (2020). Differences
in memory, perceptions, and preferences of multimedia consumer medication information: Experimental performance and self-report study. JMIR Human Factors, 7(4), e15913.
Morris, L. A., & Halperin, J. A. (1979). Effects of written drug information on patient knowledge
and compliance: A literature review. American Journal of Public Health, 69(1), 47–52. https://doi.org/10.2105/AJPH.69.1.47
Morris, L. A., Mazis, M., & Gordon, E. (1977). A Survey of the Effects of Oral Contraceptive
Patient Information. JAMA: The Journal of the American Medical Association, 238(23), 2504–2508. https://doi.org/10.1001/jama.1977.03280240050019
Mullen, R. J., Duhig, J., Russell, A., Scarazzini, L., Lievano, F., & Wolf, M. S. (2018). Best-
practices for the design and development of prescription medication information: A systematic review. Patient education and counseling, 101(8), 1351-1367.
Munsour, E. E., Awaisu, A., Hassali, M. A. A., Darwish, S., & Abdoun, E. (2017). Readability
and comprehensibility of Patient Information Leaflets for antidiabetic medications in Qatar. Journal of Pharmacy Technology, 33(4), 128–136.
https://doi.org/10.1177/8755122517706978
Nutbeam, D. (2000). Health literacy as a public health goal: A challenge for contemporary health
education and communication strategies into the 21st century. Health Promotion International, 15(3), 259–267. doi: 10.1093/heapro/15.3.259.
Parker, R., & Ratzan, S. C. (2010). Health literacy: a second decade of distinction for Americans.
Journal of Health Communication, 15(S2), 20-33.
Parnell, T. A. (2018). Health Literacy: History, Definitions, and Models. Health Literacy in
Nursing. Springer, pp. 3–31. doi: 10.1891/9780826161734.0001.
Payne, S. A. (2002). Information needs of patients and families. European Journal of Palliative
Care, 9(3), 112–114.
Petterson, T. (1994). How readable are the hospital information leaflets available to elderly
patients? Age and Aging, 23(1), 14–16. https://doi.org/10.1016/s0966-6532(97)89268-2
Ramesh, S., & Kosalram, K. (2023). The burden of non-communicable diseases: A scoping review
focus on the context of India. Journal of education and health promotion, 12(1), 41.
Schubbe, D., Scalia, P., Yen, R. W., Saunders, C. H., Cohen, S., Elwyn, G., ... & Durand, M. A.
(2020). Using pictures to convey health information: A systematic review and meta-analysis of the effects on patient and consumer health behaviours and outcomes. Patient education and counseling, 103(10), 1935-1960.
Tavakoli, H. (2012). A Dictionary of Research Methodology and Statistics in Applied Linguistics.
Tehran, Iran: Rahnama Press.
The Joint Commission (2010). Advancing Effective Communication, Cultural Competence, and
Patient- and Family-Centered Care: A roadmap for hospitals. National Health Law Program. Retrieved May 16, 2019 from http://www.jointcommission.org
US Department of Health and Human Services (2019). Health Literacy - Fact Sheet: Health
literacy basics, quick guide to health literacy. Retrieved May 19, 2019 from https://health.gov/communication/literacy/quickguide/factsbasic.htm
World Health Organization (WHO) (1998). Health literacy. Health promotion glossary. Geneva,
Switzerland.
Zarcadoolas, C., Pleasant, A., & Greer, D. S. (2005). Understanding health literacy: an expanded
model. Health Promotion International, 20(2), 195-203.
Zhou, S., Jeong, H., & Green, P. A. (2017). How consistent are the best-known readability
equations in estimating the readability of design standards? IEEE Transactions on Professional Communication, 60(1), 97–111. https://doi.org/10.1109/TPC.2016.2635720
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