Advancing Pharmacy Health Literacy Practices Through Quality Improvement
The following resources can be used as background reading for faculty or as reading assignments for students/residents. This section may be used as a reference point and resource for further exploration of health literacy quality improvement in pharmacy.
Agency for Healthcare Research and Quality (AHRQ) Health Literacy Tools
- AHRQ's health literacy tools for pharmacy:
- AHRQ's Health Literacy Universal Precautions Toolkit for Primary Care Settings.
- AHRQ Informed Consent and Authorization Toolkit for Minimal Risk Research.
- AHRQ's Training Program for Pharmacy Staff on Communication.
- Hablamos Juntos—improving patient-provider communication for Latinos.
- North Carolina Program on Health Literacy
- Key Communication Strategies
Tools for Developing or Assessing Materials
- Centers for Disease Control and Prevention's Simply Put: A Guide for Creating Easy-To-Understand Materials [PDF File].
- CDC's Plain Language Thesaurus for Health Communications [PDF File].
- Centers for Medicare and Medicaid Services' (CMS) Toolkit for Making Written Material Clear and Effective.
- National Cancer Institute Clear & Simple: Developing Effective Print Materials for Low-Literate Readers.
- Pfizer Principles for Clear Communication, 2nd Edition (see chapter 4 for guidelines). Doak, LG and Doak, CC.
- Principles of Designing a Medication Label for Community and Mail Order Pharmacy Prescription Packages . Institute for Safe Medication Practices.
Medication List Tools
- NC Health Literacy My Daily Medications [PDF File].
- Iowa Health Collaborative Medcard [PDF File].
- My Medication List—Keep it Handy [PDF File].
Health Literacy Skill Assessment Tools
- Chew LD, Bradley KA, et al. Brief Questions to Identify Patients with Inadequate Health Literacy. [PDF File].Family Medicine 2004;36(8):588-594.
- Morris NS, MacLean CD, et al. The Single Item Literacy Screener: Evaluation of a brief instrument to identify limited reading ability. [PDF File].BMC Fam Pract 2006;7:21.
- Newest Vital Sign
- Rapid Estimate of Adult Literacy in Medicine—Short Form (REALM-SF) [PDF File].
- Rapid Estimate of Adult Literacy in Medicine (REALM-R).
- Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50) [PDF File].
- TOFHLA (not free).
Assessment Tools for Pharmacies
- AHRQ's Is Our Pharmacy Meeting Patients' Needs? A Pharmacy Health Literacy Assessment Tool User's Guide.
- Medication labeling initiatives American College of Physicians (ACP) Foundation.
- ACP's Medication Labeling Project
- Institute of Medicine (IOM) "Standardizing medication labels: confusing patients less"
Health Literacy Resource Web Sites
- AHRQ Pharmacy Health Literacy Center.
- North Carolina Program on Health Literacy
- Office of Disease Prevention and Health Promotion's Health Literacy Improvement Web site.
- Health Literacy Missouri
- Health Literacy Kentucky
- Health literacy videos on the American Medical Association (AMA) website.
- Health literacy video from ACP (6-minute video).
- Teach Back Video—a technique for teaching patients.
- Provider Communication Skill: Ask for teach-back.
Quality Improvement Resources and Tools
- Health Literacy Universal Precautions Toolkit—PDSA explanation and examples.
- Health Literacy Universal Precautions Toolkit—PDSA Worksheet.
- Institute for Healthcare Improvement (IHI) - IHI PDSA Worksheet.
- American Society of Health-Systems Pharmacists (ASHP). The Pharmacist's Role in Quality Improvement.
- Krueger RA, Casey MA. (2000). Focus Groups: A Practical Guide for Applied Research. Thousand Oaks, CA: SAGE Publications.
- Reports and Initiatives found at Health Literacy Studies, Harvard School of Public Health.
- Centers for Disease Control and Prevention (CDC): Improving Health Literacy for Older Adults - Expert Panel Report 2009 [PDF File].
- National Library of Medicine's bibliography of health literacy literature.
- The Health Literacy of America's Adults: Results from the 2003 National Assessment of Adult Literacy.
- Health Literacy Interventions and Outcomes: An Updated Systematic Review, March 2011. Agency for Healthcare Research and Quality, Rockville, MD.
- Andrus MR, Roth MT. Health literacy: A review. Pharmacotherapy 2002;22(3):282-302.
- Barnett CW. Patient health literacy in the community pharmacy setting. America's Pharmacist 2006; December:63-71.
- Brown L. Low health literacy: What pharmacists can do to help. J Am Pharm Assoc 2006;46(1): 4-6.
- Davis TC, Wolf MS, et al. Literacy and misunderstanding prescription drug labels. Ann Intern Med 2006;145(12):887-894.
- Hardin LR. Counseling patients with low health literacy. Frontline pharmacist. Am J Health-Sys Pharm 2005;62(4):364-365.
- Kirk JK, Krick S, Futrell D, et al. Connecting pharmacy and literacy: the North Carolina Medication Information Literacy Project. Am J Pharm Educ 2000;64:277-83.
- Kripalani S, Jacobson KL, Brown S, et al. Development and implementation of a health literacy training program for medical residents. Med Educ Online. 2006;11(13).
- Kripalani S, Robertson R, et al. Development of an illustrated medication schedule as a low-literacy patient education tool. Patient Educ Couns 2007;66(3):368-377.
- Ngoh LN. Health literacy: A barrier to pharmacist-patient communication and medication adherence. J Am Pharm Assoc 2009;15(8):45-57.
- Osborn CY, Weiss BD, Davis TC, Skripkauskas S, Rodrigue C, Bass PF, Wolf MS. Measuring adult literacy in health care: performance of the newest vital sign. American Journal of Health Behavior. 2007 Sep-Oct; 31 Suppl 1:S36-46.
- Praska JL, Kripalani S, Seright AL, et al. Identifying and assisting low-literacy patients with medication use: a survey of community pharmacies. Ann Pharmacother 2005;39(9):1441-1445.
- Tkacz VL, Metzger A, Pruchnicki MC. Health literacy in pharmacy. Am J Health Syst Pharm 2008;65(10): 974-981.
- Warner A, Menachemi N, Brooks RG. Health literacy, medication errors, and health outcomes: Is there a relationship? Hospital Pharmacist. 2006;41:542-551.
- Warholak TL. Ensuring quality in pharmacy operations. In: Desselle S and Zgarrick D, eds. Pharmacy Management. 2nd ed. New York:McGraw Hill; 2008:125-149.
- Warholak TL, Nau DP. (2010). Quality and safety in pharmacy practice. McGraw-Hill; New York, NY.
- Warholak TL, Scott V. What is quality improvement? In: Warholak TL, Nau D (Eds). Pharmacy Quality: Improving the Safety and Effectiveness of Pharmacy Services. McGraw Hill Companies, Inc.
- Wolf MS, Davis TC, Tilson H, et al. Misunderstanding of prescription drug warning labels among patients with low literacy. Am J Health Syst Pharm 2006;63(11):1048-1055.
- Wolf MS, Williams MV, Parker RM, Parikh NS, Nowlan AW, Baker DW. Patients' shame and attitudes toward discussing the results of literacy screening. Journal of Health Communications. 2007 Dec;12(8):721-732.
- Youmans SL, Schillinger D. Functional health literacy and medication use: the pharmacist's role. Ann Pharmacother 2003;37:1726-1729.