WORLD / Health
What you don't understand could kill you
(AP)
Updated: 2007-07-24 11:30
CHICAGO - Plenty of evidence suggests that having trouble understanding
medical information is bad for your health. Now new research says it
could even be deadly. A study of patients 65 and older found that those
who couldn't understand basic written medical instructions were much more
likely to die within six years than those who had no problems grasping
the information.
The difference in the death rates remained substantial even when
researchers considered differences in the patients' health at the outset.
Inability to understand medical information and instructions makes it
hard to manage chronic illnesses from asthma to diabetes to heart
disease, said lead author Dr. David Baker, chief of general internal
medicine at Northwestern University's Feinberg School of Medicine.
That in turn can lead to declining health, frequent hospitalizations and
ultimately death, especially in older patients whose health may be more
precarious to begin with, he said.
One-fourth of the 3,260 patients in the study were considered medically
illiterate. That was based on tests of their ability to read common
medical information, including prescription labels, appointment slips and
instructions on how to prepare for an X-ray.
Almost 40 percent of those deemed medically illiterate died during the
study, compared with 19 percent of those who were literate. Factoring in
health at the outset and other variables, medically illiterate patients
were 50 percent more likely to die than the others.
The difference in death rates "was much higher than we expected," Baker
said.
The results appear in Monday's Archives of Internal Medicine.
Evidence suggests that as many as 90 million Americans have trouble with
medical literacy, said Dr. Joanne Schwartzberg, director of aging and
community health at the American Medical Association. She was not
involved in the study.
While patients of all ages are affected, "the elderly are the most highly
challenged because they're on the most drugs and have the most chronic
illnesses," she said.
Other studies have suggested poor literacy might be linked with higher
death rates, but this is the most comprehensive to date, Schwartzberg
said.
A recent small study suggested intensive education to help patients
understand medical information can reduce hospitalization and death, she
said.
The AMA has educational materials to help doctors improve literacy. Some
methods are as simple as outlining instructions in three key points, or
asking patients at the end of a doctor visit to repeat what they've just
been told, Schwartzberg said.
Baker said cutting the medical jargon and explaining things both verbally
and in writing also help.
Northwestern uses videos to boost patients' understanding. Offering
medical information in different formats makes sense since people learn
in different ways, he said.
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