Communicating Clearly About Medicines

Communicating Clearly About Medicines

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2017-09-08

Total Pages: 125

ISBN-13: 030946188X

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Research conducted over the past two decades has shown that poor patient understanding of medication instructions is an important contributor to the more than 1 million medication errors and adverse drug events that lead to office and emergency room visits, hospitalizations, and even death. Patients who have limited literacy skills, who have multiple comorbidities, and who are elderly face the greatest risk, and limited literacy skills are significantly associated with inadequate understanding and use of prescription instructions and precautions. The Agency for Healthcare Research and Quality notes that only 12 percent of U.S. adults have proficient health literacy that allows them to interpret a prescription label correctly. Given the importance of health literacy to the proper use of medications, and the apparent lack of progress in improving medication adherence, the Roundtable on Health Literacy formed an ad hoc committee to plan and conduct a 1-day public workshop that featured invited presentations and discussion of the role and challenges regarding clarity of communication on medication. Participants focused on using health literacy principles to address clarity of materials, decision aids, and other supportive tools and technologies regarding risks, benefits, alternatives, and health plan coverage. This publication summarizes the presentations and discussions from the workshop.


Informed Consent and Health Literacy

Informed Consent and Health Literacy

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2015-03-04

Total Pages: 228

ISBN-13: 0309317304

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Informed consent - the process of communication between a patient or research subject and a physician or researcher that results in the explicit agreement to undergo a specific medical intervention - is an ethical concept based on the principle that all patients and research subjects should understand and agree to the potential consequences of the clinical care they receive. Regulations that govern the attainment of informed consent for treatment and research are crucial to ensuring that medical care and research are conducted in an ethical manner and with the utmost respect for individual preferences and dignity. These regulations, however, often require - or are perceived to require - that informed consent documents and related materials contain language that is beyond the comprehension level of most patients and study participants. To explore what actions can be taken to help close the gap between what is required in the informed consent process and communicating it in a health-literate and meaningful manner to individuals, the Institute of Medicine's Roundtable on Health Literacy convened a one-day public workshop featuring presentations and discussions that examine the implications of health literacy for informed consent for both research involving human subjects and treatment of patients. Topics covered in this workshop included an overview of the ethical imperative to gain informed consent from patients and research participants, a review of the current state and best practices for informed consent in research and treatment, the connection between poor informed consent processes and minority underrepresentation in research, new approaches to informed consent that reflect principles of health literacy, and the future of informed consent in the treatment and research settings. Informed Consent and Health Literacy is the summary of the presentations and discussion of the workshop.


Health Literacy and Consumer-Facing Technology

Health Literacy and Consumer-Facing Technology

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2015-10-21

Total Pages: 172

ISBN-13: 0309376939

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The proliferation of consumer-facing technology and personal health information technology has grown steadily over the past decade, and has certainly exploded over the past several years. Many people have embraced smartphones and wearable health-monitoring devices to track their fitness and personal health information. Providers have made it easier for patients and caregivers to access health records and communicate through online patient portals. However, the large volume of health-related information that these devices can generate and input into a health record can also lead to an increased amount of confusion on the part of users and caregivers. The Institute of Medicine convened a workshop to explore health literate practices in health information technology and then provide and consider the ramifications of this rapidly growing field on the health literacy of users. Health Literacy and Consumer-Facing Technology summarizes the discussions and presentations from this workshop, highlighting the lessons presented, practical strategies, and the needs and opportunities for improving health literacy in consumer-facing technology.


Characterizing and Communicating Uncertainty in the Assessment of Benefits and Risks of Pharmaceutical Products

Characterizing and Communicating Uncertainty in the Assessment of Benefits and Risks of Pharmaceutical Products

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2014-12-19

Total Pages: 123

ISBN-13: 0309310032

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Despite the extensive body of evidence that informs regulatory decisions on pharmaceutical products, significant uncertainties persist, including the underlying variability in human biology, factors associated with the chemistry of a drug, and limitations in the research and clinical trial process itself that might limit the generalizability of results. As a result, regulatory reviewers are consistently required to draw conclusions about a drug's safety and efficacy from imperfect data. Efforts are underway within the drug development community to enhance the evaluation and communication of the benefits and risks associated with pharmaceutical products, aimed at increasing the predictability, transparency, and efficiency of pharmaceutical regulatory decision making. Effectively communicating regulatory decisions necessarily includes explanation of the impact of uncertainty on decision making. On February 12 and May 12, 2014, the Institute of Medicine's Forum on Drug Discovery, Development, and Translation held public workshops to advance the development of more systematic and structured approaches to characterize and communicate the sources of uncertainty in the assessment of benefits and risks, and to consider their implications for pharmaceutical regulatory decisions. Workshop presentations and discussions on February 12 were convened to explore the science of identifying and characterizing uncertainty in scientific evidence and approaches to translate uncertainties into decisions that reflect the values of stakeholders. The May 12 workshop presentations and discussions explored tools and approaches to communicating about scientific uncertainties to a range of stakeholders in the drug development process. Characterizing and Communicating Uncertainty in the Assessment of Benefits and Risks of Pharmaceutical Products summarizes the presentation and discussion of both events. This report explores potential analytical and communication approaches and identifies key considerations on their development, evaluation, and incorporation into pharmaceutical benefit- risk assessment throughout the entire drug development lifecycle.


Facilitating Patient Understanding of Discharge Instructions

Facilitating Patient Understanding of Discharge Instructions

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2014-12-01

Total Pages: 108

ISBN-13: 0309307414

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The Roundtable on Health Literacy brings together leaders from academia, industry, government, foundations, and associations and representatives of patient and consumer interests who work to improve health literacy. To achieve its mission, the roundtable discusses challenges facing health literacy practice and research and identifies approaches to promote health literacy through mechanisms and partnerships in both the public and private sectors. To explore the aspects of health literacy that impact the ability of patients to understand and follow discharge instructions and to learn from examples of how discharge instructions can be written to improve patient understanding of-and hence compliance with-discharge instructions, the Roundtable on Health Literacy held a public workshop. The workshop featured presentations and discussions that examined the implications of health literacy for discharge instructions for both ambulatory and inpatient facilities. Facilitating Patient Understanding of Discharge Instructions summarizes the presentations and discussions of the workshop. This report gives an overview of the impact of discharge instructions on outcomes, and discusses the specifics of inpatient discharge summaries and outpatient after-visit summaries. The report also contains case studies illustrating different approaches to improving discharge instructions.


Integrating Social and Behavioral Sciences Within the Weather Enterprise

Integrating Social and Behavioral Sciences Within the Weather Enterprise

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-02-05

Total Pages: 199

ISBN-13: 0309464226

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Our ability to observe and forecast severe weather events has improved markedly over the past few decades. Forecasts of snow and ice storms, hurricanes and storm surge, extreme heat, and other severe weather events are made with greater accuracy, geographic specificity, and lead time to allow people and communities to take appropriate protective measures. Yet hazardous weather continues to cause loss of life and result in other preventable social costs. There is growing recognition that a host of social and behavioral factors affect how we prepare for, observe, predict, respond to, and are impacted by weather hazards. For example, an individual's response to a severe weather event may depend on their understanding of the forecast, prior experience with severe weather, concerns about their other family members or property, their capacity to take the recommended protective actions, and numerous other factors. Indeed, it is these factors that can determine whether or not a potential hazard becomes an actual disaster. Thus, it is essential to bring to bear expertise in the social and behavioral sciences (SBS)â€"including disciplines such as anthropology, communication, demography, economics, geography, political science, psychology, and sociologyâ€"to understand how people's knowledge, experiences, perceptions, and attitudes shape their responses to weather risks and to understand how human cognitive and social dynamics affect the forecast process itself. Integrating Social and Behavioral Sciences Within the Weather Enterprise explores and provides guidance on the challenges of integrating social and behavioral sciences within the weather enterprise. It assesses current SBS activities, describes the potential value of improved integration of SBS and barriers that impede this integration, develops a research agenda, and identifies infrastructural and institutional arrangements for successfully pursuing SBS-weather research and the transfer of relevant findings to operational settings.


Implications of Health Literacy for Public Health

Implications of Health Literacy for Public Health

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2014-09-10

Total Pages: 136

ISBN-13: 0309303680

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Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. Nearly half of all American adults - 90 million people - have inadequate health literacy to navigate the health care system. Implications of Health Literacy for Public Health is the summary of a workshop convened by the Institute of Medicine Roundtable on Health Literacy in November 2013 that focused on the implications of health literacy for the mission and essential services of public health. The workshop featured the presentation of a commissioned paper on health literacy activities under way in public health organizations. Other presentations examined the implications of health literacy for the mission and essential services of public health, for example, community health and safety, disease prevention, disaster management, or health communication. This report includes the commissioned paper and summaries of the workshop presentations.


Virtual Clinical Trials

Virtual Clinical Trials

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2019-11-16

Total Pages: 127

ISBN-13: 0309494885

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Successful drug development relies on accurate and efficient clinical trials to deliver the best and most effective pharmaceuticals and clinical care to patients. However, the current model for clinical trials is outdated, inefficient and costly. Clinical trials are limited by small sample sizes that do not reflect variations among patients in the real world, financial burdens on participants, and slow processes, and these factors contribute to the disconnect between clinical research and clinical practice. On November 28-29, the National Academies of Sciences, Engineering, and Medicine convened a workshop to investigate the current clinical trials system and explore the potential benefits and challenges of implementing virtual clinical trials as an enhanced alternative for the future. This publication summarizes the presentations and discussions from the workshop.


Nutrigenomics and the Future of Nutrition

Nutrigenomics and the Future of Nutrition

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-07-27

Total Pages: 155

ISBN-13: 0309477670

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On December 5, 2017, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop titled Nutrigenomics and the Future of Nutrition in Washington, DC, to review current knowledge in the field of nutrigenomics as it relates to nutrition. Workshop participants explored the influence of genetic and epigenetic expression on nutritional status and the potential impact of personalized nutrition on health maintenance and chronic disease prevention. This publication summarizes the presentations and discussions from the workshop.


Health Literacy in Clinical Practice and Public Health

Health Literacy in Clinical Practice and Public Health

Author: R.A. Logan

Publisher: IOS Press

Published: 2020-06-23

Total Pages: 616

ISBN-13: 1643680757

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“Health literacy is the ultimate global currency of health and well-being. Without health literacy, medicine fails, public health fails, and people pay the cost for these failures with their lives. As this book goes to press, the world is confronted by the COVID-19 pandemic. Improving health literacy becomes increasingly important if we are to successfully confront the challenges that stress our systems of medicine and public health like never before.” (Richard H. Carmona, M.D., M.P.H., FACS, former Surgeon General of the United States, in his foreword to this book.) Two years ago, HTI published the book Health Literacy: New Directions in Research, Theory and Practice. Together with that earlier volume, this book: Health Literacy in Clinical Practice and Public Health: New Initiatives and Lessons Learned at the Intersection with other Disciplines, strives to enumerate and expand our understanding of the multidisciplinary connections which underpin the field of health literacy. The book’s balance between research and practice is a response to the feedback the editors received about the previous publication, which focused more on HL theory and research. With reports of specific health literacy research initiatives and interventions, particularly in clinical practice and public health, the book covers contemporary health literacy research and practice and is divided into three sections. Section one explores health literacy’s capacity to foster progress in clinical practice and public health; section two provides insights into health literacy initiatives and lessons learned from diverse healthcare stakeholders; and section three examines health literacy’s similarities with – and differences from – related health research disciplines. The book sets the practice and research of health literacy on an evidence-based, thoughtful, effective, efficient, and applied course. As Dr Richard Carmona says in his foreword: “It is enthusiastically recommended for all health and medical practitioners and researchers.”