Clinical Crossroads
September 14, 2011

Caring for Patients With Limited Health LiteracyA 76-Year-Old Man With Multiple Medical Problems

Author Affiliations

Author Affiliations: Dr Paasche-Orlow is Associate Professor of Medicine, Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts.

JAMA. 2011;306(10):1122-1129. doi:10.1001/jama.2011.1203

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand health information, skills, and services needed to make informed health decisions and take informed actions. Narratives from Mr J, a 76-year-old man with multiple medical problems and limited health literacy, and his physician exhibit some of the difficulties experienced by patients with limited health literacy. Clinicians can help patients with limited health literacy by removing unneeded complexity in their treatment regimens and in the health care system and by using teach-back methods to assess and improve understanding. Rather than a selective screening approach for limited health literacy, a patient-based universal precaution approach for confirming patient comprehension of critical self-care activities helps ensure that all patients have their health literacy needs identified.