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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)[email protected]
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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/
