Identifying and Improving Care for Patients with Limited Health Literacy

Limited health literacy, or the diminished capacity to obtain, understand, and act upon health-related information, has been identified as a cross-cutting factor affecting the overall quality of health care delivery and patient health outcomes, including disparities in health care.  As defined, health literacy is not simply a ‘‘patient problem,’’ but one shared by the provider and health care system with implications for the quality of medical care delivery.  Arguably, the problem of limited health literacy places greater burdens on the clinician and/or healthcare system to improve communication and ensure patient understanding, especially related to the delivery of evidence-based practice, which explicitly requires that patient preferences be incorporated into care decisions.  Available evidence suggests, however, that the literacy abilities of patients are often misclassified or that universally recommended strategies to improve patient understanding are not fully implemented.  These difficulties have led to interventions designed to improve outcomes for patients with limited health literacy.  Little agreement exists, however, on the utility of such efforts.  This presentation reviews the efficacy interventions to improve identification and treatment for at-risk patients.  The use of established best practices for improved communication is discussed from a multi-disciplinary evidence-based perspective.  Clinician and health system roles in improving care for patients with limited health literacy are also delineated, with recommendations for solutions to improve care/health outcomes and reduce racial and ethnic disparities.