The pharmaceutical industry is losing "billions of dollars in lost sales as patients fail to refill their prescriptions for chronic conditions or do not get the prescriptions filled at all," reports the December 2002 issue of MedAdNews in a major article featuring Consumer Health Information Corporation President Dorothy L. Smith, Pharm.D.

"Due to complex, scientific language, many people cannot understand the directions for taking their medication or the patient-education programs that are supposed to help them," according to the article, "Speaking the Patient's Language."

"Patients who do not understand how to take their medications may take the drugs incorrectly or not take them at all," MedAdNews states.

The article quotes Dr. Smith as saying that "lost sales from unfilled and unrefilled prescriptions are $8 billion annually. Beyond the lost sales, poor health outcomes hurt not only patients, but cost the nation's healthcare system about $73 billion annually."

The article notes that Dr. Smith has identified "a sequence of steps for consumers to follow to achieve health literacy." These steps are:

• Read the information
• Understand the information
• Be convinced the information is important
• Take action
• See results from the therapy

Patients Need To Be Convinced
MedAdNews quotes Dr. Smith as stressing that health literacy is more than bringing information down to the appropriate reading level. "They have to be convinced to take the medication... Ten percent of people in the doctor's office decide not to even fill the prescription, but they do not tell anybody."

A prime example of how noncompliance can negatively affect healthcare costs, Dr. Smith notes, is the fact that half the patients diagnosed with hypertension stop taking their medications in the first year because they are not convinced that the medications are helping them.

“When 50% of them stop, that group could suffer more serious complications and kidney damage, a stroke, or other serious problems that require not only emergency and hospitalization, but can have some people end up in nursing homes," Dr. Smith says.

When addressing health literacy, Dr. Smith says that "pharmaceutical companies and physicians should prepare materials from the perspective of the patient. We have to put ourselves in the shoes of the patient. We need to pretend that we are a patient, and if we are a patient we need information that we can understand, that we can trust, and that we will keep so that we can refer to. The written instructions prepared by a pharmaceutical company will be more effective if the health-care professional can refer to them during their counseling."

Effective Patient Compliance Strategy
In the keynote address before the Norfleet Executive Forum on Health at the University of Tennessee Health Science Center, Dr. Smith stressed that "the only way to effectively guide a patient through a treatment plan is to develop a patient compliance strategy at the outset."

She stated that a patient compliance strategy based on sound progressive patient education principles will be based on these steps:

• Identify potential literacy and compliance problems that patients can be expected to encounter in "real life."
• Identify potential barriers that health professionals will encounter (such as time, space, reimbursement, etc.).
• Determine the information that patients will need at each stage of their decision-making process (initial prescription, first refill, etc.).
• Identify behavioral modification techniques that will help keep patients motivated to continue their treatment.

"It doesn't make sense to produce materials that consumers cannot understand," Dr. Smith told the Forum. "Too many consumers are suffering because they do not receive the right kind of health information. Patients make serious medication errors because they are not receiving health information they can understand and use."

Consumer Health Information Corporation (www.consumer-health.com) is internationally recognized for its innovative patient information programs. The organization has produced a broad range of print and audiovisual programs for pharmaceutical companies, consumer organizations, and health care professionals that have helped millions of people learn to make wise decisions about their health and medicines. The company is also a teaching site for several schools of pharmacy across the United States.