Aims: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.Study design: 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 companydesigned 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.
Down syndrome is the most common genetic cause of intellectual disability and increases the risk of a range of medical problems that may have implications for oral health. Children diagnosed with Down syndrome should be signposted to dental services as part of their schedule of health checks. To ensure that appropriate access and support are available from the dental team, it is important that dental professionals are familiar with medical and dental conditions and characteristics that occur with increased frequency in patients with Down syndrome. CPD/Clinical Relevance: Down syndrome is the most common chromosomal abnormality likely to present in clinical dental practice. This paper provides guidance for dental professionals for dental checks and surveillance of the developing dentition for children with Down syndrome.
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