Abstract
Objective:Patient information leaflets (PILs) are widely used to reinforce or illustrate health information and to complement verbal consultation. The objectives of the study were to assess the readability and presentation of PILs published by Allergy UK, and to conduct a longitudinal assessment to evaluate the impact of leaflet amendment and revision on readability. Methods:Readability of Allergy UK leaflets available in 2013 was assessed using Simple Measure of Gobbledegook (SMOG) and Flesch-Kincaid Reading Grade Formula. Leaflet presentation was evaluated using the Clear Print Guidelines of the Royal National Institute of Blind People (RNIB) and the Patient Information Appraisal System developed by the British Medical Association (BMA). Changes in the leaflets’ readability scores over five years were investigated. Results:108 leaflets, covering a wide range of allergic conditions and treatment options, were assessed. The leaflets had average SMOG and Flesch-Kincaid scores of 13.9 (range 11-18, SD 1.2) and 10.9 (range 5-17, SD 2.1) respectively. All leaflets met the RNIB Clear Print guidelines, with the exception of font size which was universally inadequate. The leaflets scored on average 10 (median 10, range 7-15) out of a maximum of 27 on the BMA checklist. The overall average SMOG score of 31 leaflets available in both 2008 and 2013 had not changed significantly. The process of leaflet revision resulted in 1% change in readability scores overall, with a predominantly upward trend with six leaflets increasing their readability score by >10% and only three decreasing by >10%. Conclusion:Allergy-related patient information leaflets are well presented but have readability levels that are higher than those recommended for health information. Involving service users in the process of leaflet design, together with systematic pre-publication screening of readability would enhance the accessibility and comprehensibility of written information for people with allergy and their careers.
Highlights
Allergic disorders are common in the developed world
Patient information leaflets (PILS) are used to augment the advice offered during the clinical encounter [4], empowering patients to become more involved in their treatment decisions and to take greater self-care [5]
Completed primary school education is needed for reading material with a Simple Measure of Gobbledegook (SMOG) score of 3-8, secondary school education is needed for SMOG score of 9-12, and tertiary education is needed for SMOG score of 13 and above [11]
Summary
Allergic disorders are common in the developed world. One in three people in the UK and one in five people in the USA suffer from allergic disease [1,2]. The management of allergies is primarily dependent on the patient being aware of the triggers and reducing exposure to the relevant allergens. This requires the patient to have a clear understanding about their condition and how to manage their symptoms effectively. Patient information leaflets (PILS) are used to augment the advice offered during the clinical encounter [4], empowering patients to become more involved in their treatment decisions and to take greater self-care [5]. Good information leaflets have been found to be helpful in reducing anxiety about patients’ illness or treatment [6], improving compliance or concordance with treatment [7], and contributing to improved illness outcomes
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