Health literacy in kidney disease: Review of the literature and implications for clinical practice

Table 1 Clinical "red flags" for limited health literacy

Patient registration forms that are incomplete or inaccurately completed

Non-adherence with medications or treatments

Frequently missed appointments

Lack of follow-through with labs, imaging tests, or referrals

Unable to name medications, explain what medications are for, or explain timing of medication administration

May offer excuses to deflect reading tasks

"I forgot my glasses"

"Let me bring this home so I can discuss it with my children"

Seldom have questions

Seek help only when illness is advanced

Have difficulty explaining medical concerns

Table 2 Clear health communication techniques

Explain things clearly in plain language

Avoid medical jargon (for example, state "long-term" rather than "chronic")

Avoid vague terms such as "negative" test result

Slow down

Focus on 1-3 key points or messages - and repeat

Confirm understanding using teach-back

"I want to be sure that I explained your medication correctly. Can you tell me how you are going to take this medication?"

Effectively encourage patients to ask questions

"What questions do you have?" rather than "Do you have any questions"

Use analogies and pictures

Use patient friendly educational materials

4th-6th grade reading level

Picture-based

Write down important instructions