Introduction
The benefits of educating a patient are clear, but a patient must understand the information they are receiving in order for it to benefit their healthcare.1 Health literacy (HL) has been defined as; ¿the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions¿ 2. Users of psychiatric services are more likely to have an impaired reading ability. 3
Objective
To design a user-friendly PIL on clozapine, which is appropriate to the health literacy level of the clozapine population.
Methods
All patient receiving clozapine in the Mercy University Hospital (MUH) were eligible for inclusion unless deemed clinically too unwell. The Rapid Estimate of Adult Literacy in Medicine (REALM)4 screening instrument was administered and scored out of 66. A new PIL was designed for patients using the National Adult Literacy Agency (NALA) approved guide to plain English5. This PIL was compared with the company PIL and both were assessed for readability using the Flesch Reading Ease Score (FRES) 6 and Flesch-Kincaid Grade Level (FKGL).7
Results and Conclusions:
40 patients completed the REALM with an average score of 60.58 (±8.7). Table 1 shows the results of the readability score for PILs:
Table 1: Comparison of readability of the PILs .
| FRES* | FKGL |
Company-designed PIL | 49.7 | 10.3** |
Pharmacist-designed PIL | 62.0 | 8.1*** |
*The higher the score, the easier the document is to understand.
**A FKGL of 10.3 equates to an approximate reading age of 15 years.
***A FKGL of 8.1 equates to an approximate reading age of 13 years.
Application to practice:
The pharmacist-designed PIL was found to be an easier document to read than the company-produced PIL.