AHRQ Health Literacy Tool Helps University of Wisconsin School of Pharmacy Educate Students and Community Pharmacists
Second-year students at the University of Wisconsin School of Pharmacy are helping educate community pharmacists across the State to identify and overcome limited health literacy among their patients. After taking a survey modified from an AHRQ tool (“Is Our Pharmacy Meeting Our Patients’ Needs?”), 61 percent of community pharmacists reported making at least one change as a direct result of students’ activities in their pharmacies, reporting an average 3.4 changes per pharmacist.
Susanne Barnett, PharmD, Clinical Assistant Professor, explains, “Not only do colleges and schools of pharmacy have an obligation to train pharmacy students to competently work with patients with limited health literacy, schools also have an obligation to their communities to raise awareness about the prevalence of patients with limited health literacy, as well as its implications and interventions that can be used to make a difference in the care of these patients.”
Community pharmacy sites—most commonly, chain pharmacies dispensing 100 to 500 prescriptions per day in cities with 100,000 or more persons—serve as educational settings for second-year doctor of pharmacy students. As part of an experiential education module on health literacy that is part of the required second-year doctor of pharmacy curriculum, students spend 20 hours over four visits completing health literacy activities in the pharmacy. During visits, students work through surveys and guided worksheets to explore various health literacy topics.
“In order to assist patients in properly taking their medications and preventing negative consequences associated with limited health literacy, it is important that pharmacists understand the various methods and tools available to identify and assist patients with limited health literacy,” Barnett says.
In selecting resources to use in the school’s program, Barnett notes, “Using tools created and endorsed by AHRQ, a well-respected national institution, indicates to students and community pharmacists that inadequate health literacy is a national crisis, as well as a vital factor affecting patients’ understanding of medication therapy and thus health outcomes. The various surveys contained within the toolkit and adapted for this course emphasize that multiple components must be considered when assessing interventions that can identify and assist individuals with limited health literacy. AHRQ’s Pharmacy Health Literacy resources were vital to the success of our students in making an impact on clinical practice within community practice sites.”
Using the survey data collected during visits, students create presentations designed to educate pharmacists and technicians about the health literacy of their patient population. Students give a 10-minute presentation to staff at their assigned community pharmacy during the final visit that assesses the staff’s ability to identify, and their confidence in identifying, limited health literacy patients and tools to improve patient medication use. Presentations are created from a common outline provided to students to standardize information presented to the pharmacy staff.
According to Barnett, the students’ presentations also provide specific examples of areas in which the pharmacy adequately assists patients with limited health literacy, as well as areas in need of improvement. During the presentation, students provide the following:
- Background information about health literacy
- Methods that can be used to identify patients with limited health literacy
- Commonly used tools to assist patients
- Strengths and weaknesses of the physical pharmacy and staff in assisting, identifying, and resolving health literacy–related issues
Following the students’ presentations, 33 percent of pharmacists reported making changes to better identify limited health literacy patients, 36 percent reported making changes to improve care provided to this patient population, and 28 percent reported making changes to both.
The most common change was that pharmacists reported decreasing the amount of medical jargon spoken during patient consultations. Additional changes included the following:
- Increasing the number of open-ended questions asked to patients
- Decreasing the number of multisyllable words spoken
- Asking patients to repeat or verify how to use their medications during consultations
“Because knowledge retention rates are highest when information is taught to others, we believe the student involvement at community pharmacy sites was a unique opportunity to positively augment the health literacy learning experience of students, while at the same time educating community pharmacists on this important topic,” says Barnett.
She continues, “The results of the community pharmacist survey suggest that pharmacy students were indeed successful in influencing pharmacists to make changes to their practice to better identify and serve patients with limited health literacy.”
Jacobson KL, Gazmararian JA, Kripalani S, et al. Is Our Pharmacy Meeting Patients’ Needs? A Pharmacy Health Literacy Assessment Tool User's Guide. AHRQ Publication No. 07-0051, October 2007. Agency for Healthcare Research and Quality, Rockville, MD.