Mayo Clinic Proceedings Home

Functional Health Literacy and Understanding of Medications at Discharge

      The objective of this study was to evaluate patient knowledge of newly prescribed medication after hospital discharge. We reviewed the charts of 172 patients who were discharged from February 1, 2006, through April 25, 2006, from the internal medicine residency service at a community-based teaching hospital with prescriptions for 1 or more new medications. Between 4 and 18 days after discharge, patients were contacted by telephone and asked about the name, number, dosages, schedule, purpose, and adverse effects of the new medication(s) and whether they could name their medical contact person. We recorded the number of correct answers, patient age, and years of education. Of the survey respondents, 86% were aware that they had been prescribed new medications, but fewer could identify the name (64%) or number (74%) of new medications or their dosages (56%), schedule (68%), or purpose (64%). Only 11% could recall being told of any adverse effects, and only 22% could name at least 1 adverse effect. Older patients tended to answer fewer questions correctly (P=.02). We observed no association between the number of correctly answered questions and years of education (P=.57), time between discharge and survey (P=.17), or number of new medications (P=.65). Overall, we found that patients had limited knowledge about their medications after discharge from an internal medicine residency service, with age but not years of education significantly associated with level of knowledge.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Mayo Clinic Proceedings
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Healthy People 2010: Health communication. 2000:20. Office of Disease Prevention and Health Promotion Web site.
        (Accessed March 11, 2008.)
        • Kirsch IS
        • Jungeblut A
        • Jenkins L
        • Kolstad A
        Adult literacy in America: a first look at the findings of the National Adult Literacy Survey. 3rd ed. National Center for Education Statistics Web site.
        (Accessed March 11, 2008.)
      2. Kindig D Affonso D Chudler E Health Literacy: a Prescription to End Confusion. National Academies Press, Washington, DC2004 (Accessed March 12, 2008.)
        • Baker DW
        • Parker RM
        • Williams MV
        • Clark WS
        Health literacy and the risk of hospital admission.
        J Gen Intern Med. 1998; 13: 791-798
        • Mancuso CA
        • Rincon M
        Impact of health literacy on longitudinal asthma outcomes.
        J Gen Intern Med. 2006; 21: 813-817
        • Lincoln A
        • Paasche-Orlow MK
        • Cheng DM
        • et al.
        Impact of health literacy on depressive symptoms and mental health-related quality of life among adults with addiction.
        J Gen Intern Med. 2006; 21: 818-822
        • Lindau ST
        • Basu A
        • Leitsch SA
        Health literacy as a predictor of follow-up after an abnormal Pap smear: a prospective study.
        J Gen Intern Med. 2006; 21: 829-834
        • Blendon RJ
        • DesRoches CM
        • Brodie M
        • et al.
        Views of practicing physicians and the public on medical errors.
        N Engl J Med. 2002; 347: 1933-1940
        • Kripalani S
        • Paasche-Orlow MK
        • Parker RM
        • Saha S
        Advancing the field of health literacy [editorial].
        J Gen Intern Med. 2006; 21: 804-805 j.1525-1497.2006.00568.x
        • Carmona RH
        Health literacy: a national priority [editorial].
        J Gen Intern Med. 2006; 21: 803
        • Makaryus AN
        • Friedman EA
        Patients' understanding of their treatment plans and diagnosis at discharge.
        Mayo Clin Proc. 2005; 80: 991-994
        • Gazmararian JA
        • Baker DW
        • Williams MV
        • et al.
        Health literacy among Medicare enrollees in a managed care organization.
        JAMA. 1999; 281: 545-551
        • King JL
        • Schommer JC
        • Wirsching RG
        Patients' knowledge of medication care plans after hospital discharge.
        Am J Health Syst Pharm. 1998; 55: 1389-1393
        • Davis TC
        • Wolf MS
        • Bass III, PF
        • et al.
        Literacy and misunderstanding prescription drug labels.
        Ann Intern Med. 2006 Dec 19; 145 (Epub 2006 Nov 29.): 887-894
        • Toren O
        • Kerzman H
        • Koren N
        • Baron-Epel O
        Patients' knowledge regarding medication therapy and the association with health services utilization.
        Eur J Cardiovasc Nurs. 2006 Dec; 5 (Epub 2006 Jan 19.): 311-316
        • Phillips CO
        • Wright SM
        • Kern DE
        • Singa RM
        • Shepperd S
        • Rubin HR
        Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis.
        JAMA. 2004; 291: 1358-1367
        • Howard DH
        • Gazmararian J
        • Parker RM
        The impact of low health literacy on the medical costs of Medicare managed care enrollees.
        Am J Med. 2005; 118: 371-377
        • Gandhi TK
        • Weingart SN
        • Borus J
        • et al.
        Adverse drug events in ambulatory care.
        N Engl J Med. 2003; 348: 1556-1564
        • Gurwitz JH
        • Field TS
        • Harrold LR
        • et al.
        Incidence and preventability of adverse drug events among older persons in the ambulatory setting.
        JAMA. 2003; 289: 1107-1116
        • Forster AJ
        • Murff HJ
        • Peterson JF
        • Gandhi TK
        • Bates DW
        The incidence and severity of adverse events affecting patients after discharge from the hospital.
        Ann Intern Med. 2003; 138: 161-167
        • Yedidia MJ
        • Gillespie CC
        • Kachur E
        • et al.
        Effect of communications training on medical student performance.
        JAMA. 2003; 290: 1157-1165
        • American Medical Association Foundation
        Health Literacy Train-the-Trainer Program. Chicago, IL: American Medical Association Foundation, c1995-2006 [updated 2005 Jun 02].
        (Accessed April 14, 2008.)
        • Sudore RL
        • Landefeld CS
        • Williams BA
        • Barnes DE
        • Lindquist K
        • Schillinger D
        Use of a modified informed consent process among vulnerable patients: a descriptive study.
        J Gen Intern Med. 2006; 21: 867-873
        • Calkins DR
        • Davis RB
        • Reiley P
        • et al.
        Patient-physician communication at hospital discharge and patients' understanding of the postdischarge treatment plan.
        Arch Intern Med. 1997; 157: 1026-1030
        • Davis TC
        • Wolf MS
        • Bass III, PF
        • et al.
        Low literacy impairs comprehension of prescription drug warning labels.
        J Gen Intern Med. 2006; 21: 847-851

      Linked Article

      • Medication Literacy Is a 2-Way Street
        Mayo Clinic ProceedingsVol. 83Issue 5
        • Preview
          Effective spoken and written communication of information about medicine to patients is crucial to the success of treatments. The effectiveness and safety of medicines cannot be maximized unless patients understand their role in the medicine-taking process. However, we generally communicate this information badly. Great effort and much time and money are devoted to the front end of developing medicines, but at the end of that process, when the medicine is actually handed over to patients, much is left to chance.
        • Full-Text
        • PDF