When is an ice cream label a health literacy tool?

When Dr. Barry Weiss decided to use an ice cream label as a tool to asses whether we (patients) are able to understand medical instructions. Funded by Pfizer-backed Clear Health Communication initiative, Weiss’s research resulted in the creation of “The Newest Vital Sign.”

A health literacy assessment tool, with findings published in the Annals of Family Medicine.

However, the document, Why does an ice-cream label work as a predictor to understand medical instructions, adds: “even patients with better reading skills could have difficulties interpreting the label.” What a relief to read that!  When I look at the ice cream (or any nutritional label) I am often confounded. The score card for this newest vital sign also sends me into paralysis, as most math calculations do.

Another component of the Clear Health Communication project is Help Your Patients Succeed. Aimed at doctors, it’s designed to give a slightly broader view of what we patients need. Included is the astoundingly basic observation that simple words are confusing when out of context. Stool and dressing being two of such words. It’s these small words that have inspired me to embark on a glossary. It’ll have the medical word, and then the various ways we, the untrained-in-jargon, say it.

For example, sensitive, thoughtful, patient-centered health care professionals understand that for many patients with diabetes it’s best referred to as their “sugars.” Likewise a diuretic is a “water pill.” (I wager the the various euphemisms for “stool” will take up some space in a glossary).

By tuning into our day to day terminology, instead of requiring us to learn medical jargon, a change can be affected. Health communication goes beyond health literacy. It requires a willingness to understand and respect how we learn, process and act on information and education, and not to assume we each interpret and understand directions the same way. I’d fail the ice cream label test simply out of fear of being judged by my inability to de-code and analyze allegedly simple information.

Consider a recent caution from the Institute of Safe Medication Practices Canada, entitled, How to Take Your Medicine:

Sometimes, the correct way to take your medications may not be obvious. Here are some examples: If the label of your prescription says “Take three tablets daily,” should you take all three tablets once a day, or one tablet three times a day? If you are prescribed one tablet four times a day, should you take one tablet every six hours around the clock or can you just space out the doses during the hours that you are awake? Should you take your medicine with food, or on an empty stomach? The answers depend on the medicines you are taking. If a medicine is not taken properly, it may not work as well as it should or could cause you harm.

As I find myself looking at a meds instruction that tells me to “take with plenty of liquids,” I know I have to resist the urge to reach for my liquid of preference: tequila.

Kathy Kastner is Founder and President of Ability for Life.

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