Praska Jessica L, Kripalani Sunil, Seright Antoinette L, Jacobson Terry A
Department of Veterans Affairs, Pharmacy Service, Denver, CO 80220-3808, USA.
Ann Pharmacother. 2005 Sep;39(9):1441-5. doi: 10.1345/aph.1G094. Epub 2005 Jul 26.
Nearly one-half of adult Americans have limited functional literacy skills. Low patient literacy is associated with poor medication adherence and health outcomes. However, little is known about how pharmacies address literacy-related needs among patrons.
To determine the frequency with which pharmacies identify and provide appropriate assistance to patients with limited literacy skills and provide specific recommendations to help improve pharmacists' recognition of low health literacy, as well as strategies to improve adherence in this population.
Through a telephone-based survey of Atlanta-area pharmacies, we obtained information on (1) whether the pharmacy attempted to identify patients with limited literacy skills, (2) what measures were taken by the pharmacy to optimize the health care of low-literacy patients, especially with regard to medication adherence, and (3) what services the pharmacy offered to improve adherence in general.
The response rate among eligible pharmacies was 96.8% (N = 30). Only 2 (7%) pharmacies reported attempting to identify literacy-related needs among their patrons. One of these facilities provided additional verbal counseling to assist low-literacy patients, and the other pharmacy involved family members, provided verbal counseling, and had patients repeat instructions to confirm comprehension. Most pharmacies reported availability of adherence aids that could help low-literacy patients if such patients were identified and targeted to receive additional assistance. These included verbal and written counseling (offered at 73% of pharmacies), packaging or organizing aids (27%), refill services (17%), and graphic or multimedia aids (13%).
Pharmacies infrequently attempt to identify and assist patients with limited literacy skills.
近一半的美国成年人具备有限的实用读写能力。患者读写能力低与用药依从性差及健康状况不佳相关。然而，对于药房如何满足顾客中与读写能力相关的需求，我们了解甚少。
确定药房识别并为读写能力有限的患者提供适当帮助的频率，并提供具体建议以帮助提高药剂师对低健康素养的认知，以及改善该人群依从性的策略。
通过对亚特兰大地区药房进行电话调查，我们获取了以下信息：（1）药房是否试图识别读写能力有限的患者；（2）药房采取了哪些措施来优化低读写能力患者的医疗保健，尤其是在用药依从性方面；（3）药房提供了哪些服务来总体上提高依从性。
符合条件的药房的回复率为96.8%（N = 30）。只有2家（7%）药房报告试图识别其顾客中与读写能力相关的需求。其中一家机构提供了额外的口头咨询以帮助低读写能力患者，另一家药房让家庭成员参与，提供口头咨询，并让患者重复指示以确认理解。大多数药房报告称，如果识别出低读写能力患者并针对性地提供额外帮助，有可用的依从性辅助工具可以帮助他们。这些工具包括口头和书面咨询（73%的药房提供）、包装或整理辅助工具（27%）、续方服务（17%）以及图形或多媒体辅助工具（13%）。
药房很少试图识别并帮助读写能力有限的患者。
