Health literacy

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Health Literacy views:

The clinician viewpoint

Health Literacy views:

The clinician viewpoint

Barcelona. January 14th, 2008

Joan Escarrabill MDHospital Universitari de Bellvitge

L’Hospitalet (Barcelona)jescarra@csub.scs.es

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Agenda

Doctors and health education

SEPAR and health literacy

Health literacy anf Web 2.0

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Patient education

1980 2 vols

1853 pages

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PatientEducation

Improvescompliance

BetterOutcomes = =

Compliance

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Compliance

50% of medicines prescribed for people with chronic conditions are not taken

Jones G. BMJ 2003;327:819-20

The perception of patients and doctors of the risks and benefits differs.

High quality information is essential

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Adherence & frequency of doses

Osterberg L & Blaschke T. N Engl J Med. 2005;353:487-97.

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Smoking habit in COPD patients

Med Clin (Barc) 1989;93:772-4

of patients on LTOT were current smokers27%

Current smokers

23%Hernández. Eur Resp J 2003;21:58-6.

Hospital at home

26%Eur Respir J 2000;16:1037-42

EFRAM Study

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Smoking & LTOT in Denmark

25.1%

Ringbaek TJ, Lange P. Respir Med 2006;100:218-25

Danish register

Current smokers 21.1% NS

1994 2000

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At home...I was working at home reading my old

Chest diseases textbook and my daughter (16 yrs old) asked me...

• What are you doing?

-I’m working in a presentation

• What’s the topic

- Patient education

• Uff, always the same... Doctors are prepotent and arrogant

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Coulter A. BMJ 1999;319:719-20

Paternalism is endemic in the NHS

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LTOT prescriptions without ABG criteria

1984 1995

56% 40%

Escarrabill. Lancet 1985:ii:779. Farrero. Arch Bronconeumol 1998;34:374-8

LTOT Danish registerLTOT Danish register 1994 65% Incorrect prescription

2005 LTOT < 15 h/day65%

Follow-up withdraw33%

Current smokers on LTOT21%

Ringbaek TJ & Lange P. Respir Med. 2006;100:218-25.

LTOT: compliance with guidelines

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61

8695

40

69

81

0

10

20

30

40

50

60

70

80

90

100

20 months 50 months

MRC (O2 - 1981)

Cooper (1987)

Carrera (1997)

LTOT: Improvement of the survival through the time

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JAMA 1998;279:1309

Provision of adequate context for new research results is one of the main problems in presenting medical and health news for the public.

a tool for more effective communication between patients and physicians.

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Only one Patient page per issue Difficult access for the patient Not necessarily related to specific patient

needs

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Health literacy vs poor communication

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A powerful tool....

The pediatrician of my

daughter typed systematically

all the recommendations in an

old typewriter

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Health literacy

HealthLiteracy

Health Education

The degree to which people have de capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

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Impact of limited health literacy

Fill out complex forms

Locate providers and services

Share personal information such as health history

Take care of yourself

Manage a chronic disease

Understand how to take medicines

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Agenda

Doctors and health education

SEPAR and health literacy

Health literacy anf Web 2.0

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www.separ.es/

Public information about respiratory diseases

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www.separ.es/

COPD

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www.separ.es/

COPD

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SEPAR pacientes

Doctors and nurses promoting activities especifically related to care.

Participation of the patients in the activities of the society

Partients in the scientific meetings

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www.separ.es/

Sleep apnea

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Sleep disorders

High prevalence (>5% adults) Therapy for life in most cases Changes in life style Intrusive

Sleep Apnea Syndrome

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Guarantee the education through the years.

Education to a greater number of patients.

Doing intelligible the education.

Sharing the point of view of the patient on the illness

Tutor patient in sleep disorders

Benefits

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Tutor patient: development of the project

Main characteristics of the disease Health habits and therapy The devices Complications Social impact Teaching skills

1 Experts identify the main topics

www.universidadpacientes.org/ www.separ.es

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Tutor patient: development of the project

2 Definition of competences

What competences should have the tutor patient to be able to teach other patients?

3 Asking the patients

InterviewsFocus groups

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Tutor patient: development of the project

Health professionals

Tutor patient

Patient

Patient

PatientPatient

Patient

Tutor patient

Patient

Patient

PatientPatient

Patient

Tutor patient

Patient

Patient

PatientPatient

Patient

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Agenda

Doctors and health education

SEPAR and health literacy

Health literacy anf Web 2.0

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BMJ 2006;333:1143-5

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www.patientslikeme.com/