American Academy of Physician Assistants Recommends AHRQ's Health Literacy Universal Precautions Toolkit

Upon expanding its health literacy policy in 2011, the American Academy of Physician Assistants (AAPA) specifically cited AHRQ's "Health Literacy Universal Precautions Toolkit" as a valuable resource that offers primary care practices a way to assess and improve health literacy efforts with patients.

AAPA's revised health literacy policy, which was approved by the AAPA House of Delegates, recommends the use of AHRQ's toolkit to its 44,000 members. AAPA promoted the revised policy and the toolkit through its member newsletters and on its Web site. Since it can be difficult to identify patients who may not understand health information, the toolkit helps primary care practices take a systematic approach to reducing the complexity of medical care so patients can better understand.

According to James E. Anderson, PA-C, ATC, who served as the lead author of AAPA's revised health literacy policy, the physician assistant profession can address the issue of limited health literacy by focusing efforts to foster better communication with patients and by using available resources such as AHRQ's toolkit.

Anderson says the toolkit is a great idea, because it can "help revolutionize how providers and their assistants should be addressing health literacy, which has become a more important issue. It's not as simple as 'if only I could get my patients to understand their instructions.'"

Health literacy is the ability to obtain, process, and understand basic health information and services necessary to make appropriate decisions. "Universal precautions" refers to taking specific actions that reduce risk for patients when it is unclear who may be affected. Health literacy universal precautions are needed because providers don't always know which patients have limited health literacy.

"We need to remember that while some patients can't read or write, health literacy is broader than just literacy alone. Patients across the health care spectrum, ranging from the highest educational level to those with minimal schooling, leave our offices unsure of what we want them to do with their medications and treatment regimens. Universal precautions means that we need to assume all of our patients may be struggling with understanding what we think of as being very simple, and their care may be suffering because of it," Anderson says.

It is estimated that more than one third of patients have limited health literacy, which results in not understanding what they need to do to take care of their health. Limited health literacy is associated with poor management of chronic diseases, poor ability to understand and adhere to medication plans, increased hospitalizations, and poor health outcomes.

Anderson says, "The toolkit is helping to focus more attention on the importance of addressing health literacy. Over time, the biggest potential impact is that the toolkit will help physician assistants resolve the health literacy issue through having respectful relationships with patients and a shared responsibility for effectively communicating with them."