title: Health literacy and the clozapine patient.
abstract: OBJECTIVE
  To estimate the prevalence of limited health literacy in patients receiving clozapine for schizophrenia. To develop and produce a pharmacist-designed clozapine patient information leaflet (PIL) which has a higher readability score than the company-produced PIL.
  
  
  METHODS
  This was a cross sectional prevalence study.
  
  
  METHODS
  Ethical approval for the study was granted by the local ethics committee. Patients, over 18 years, attending the Clozapine Clinic of a Cork urban teaching hospital, were asked to participate in the study. Demographics such as gender, age, employment and smoking status, were gathered from all participants. The total daily clozapine dose, duration of clozapine treatment, and information regarding the clozapine DVD was also noted. The Rapid Estimate of Adult Literacy in Medicine (REALM) health literacy (HL) screening tool was then administered to each patient. A user-friendly PIL on clozapine was designed by the pharmacist, which was assessed for readability and compared to the company-produced PIL using the FRES and FKGL. Data were analysed using SPSS Version 15.
  
  
  RESULTS
  Forty patients (65% male, 95% unemployed and 70% smokers) of average age 38.0 years (+/- 11.2) completed the REALM. The average score was 60.6 (+/- 8.7). Twenty-nine patients (72.5%) were found to have "adequate" health literacy. The remaining eleven patients were found to have either "marginal" or "low" health literacy. The pharmacist-designed PIL would have been readable by 95% of the study population, in contrast to 72.5% with the company-designed PIL.
  
  
  CONCLUSIONS
  More than a quarter of the population were found to have marginal or low health literacy. Patient information should be matched to the health literacy level of the target population.
authors.affiliation: University of Cork, Cork, Ireland.
authors.forename: Susan
authors.initials: S
authors.lastname: Brosnan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barron
authors.forename: L J
authors.initials: LJ
authors.lastname: Sahm
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003024:Clozapine / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D057220:Health Literacy; D006801:Humans; D007494:Ireland; D008297:Male; D010353:Patient Education as Topic; D015995:Prevalence; D011932:Reading; D012559:Schizophrenia / Q000188:drug therapy*; D013664:Teaching Materials
chemical_list: D014150:Antipsychotic Agents; D003024:Clozapine