Online patient education materials for statins often exceed recommended reading level
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Key takeaways:
- Many online patient education materials about statins are written at a 10th grade reading level.
- The most readable patient education materials on statins also had the lowest reliability.
Online patient education materials about statins often exceed the reading level of many patients, and reliability varies widely across sources, complicating efforts to improve medication initiation and adherence, researchers reported.
In an analysis of 211 online patient education materials published in the American Journal of Preventive Cardiology, researchers also found that more readable patient materials tended to be less reliable, posing further challenges for patients with lower health literacy.
Reading level of statin information
“Despite the well-established safety and efficacy of statins, these cholesterol-lowering drugs remain underutilized and frequently discontinued by patients who meet guideline criteria for statin therapy,” Summer Ngo, BS, a research coordinator with the division of cardiovascular medicine at Stanford University School of Medicine, told Healio. “This can be attributed, in part, to misinformation regarding statins and their potential side effects, which may deter patients from starting or continuing statin therapy. Recognizing the influential role that online health information plays in shaping patients’ medical decisions today, we were interested in assessing the readability and reliability of online patient education materials related to statins. These materials should be written at an appropriate reading level for the general public to ensure that patients adequately understand the safety and effectiveness of statins. Equally important, online information about statins should come from reliable, trustworthy sources to counter the spread of misinformation.”
Ngo, Fatima Rodriguez, MD, MPH, FACC, FAHA, FASPC, associate professor in cardiovascular medicine and section chief of preventive cardiology at Stanford University, and colleagues identified the top 20 search results for each of 17 statin-related terms to assess 211 online patient education materials with unique content. Researchers then grouped each online patient education site into categories based on two independent reviewers: government online patient education materials (national, state or local government agencies); health care/nonprofit (major health systems and nonprofit organizations with a specific CV health focus); industry/commercial (pharmaceutical manufacturers and online pharmacies); lay press (health care-oriented news organizations); and dictionary/encyclopedia. Researchers calculated grade-level readability for each site using five standard readability metrics and compared with AMA-recommended readability recommendations. The researchers evaluated the reliability of each online patient education material using the JAMA benchmark criteria for online health information and certification from Health on the Net (HONCode).
Online patient education materials about statins exceeded the recommended sixth grade AMA reading level, with an overall average reading grade level of 10.9. The average JAMA benchmark criteria score was 2.13 on a scale of 0 to 4, with higher scores indicating higher reliability. Sixty percent of the online patient education materials were HONCode-certified. The researchers also observed an inverse association between readability and reliability, noting that the most readable results were from industry and commercial sources, whereas the most reliable sites were from lay press sources.
Readability and reliability
“We found that online patient education materials about statins averaged a 10th grade reading level, which is well above the American Medical Association’s readability recommendations that they be written at or below a sixth grade level,” Ngo told Healio. “The most readable statin online patient education materials were from industry/commercial and health care/nonprofit sources, while the most reliable sites were from lay press sources. We were surprised to find an inverse relationship between the readability and reliability of statin online patient education materials, with the most readable having the lowest reliability.”
The researchers noted that a lack of accessible, high-quality online health information may contribute to statin nonadherence.
“The cardiovascular care team can help improve statin utilization and adherence by providing more readable information about statins that is tailored to each patient’s level of understanding, guiding patients to reliable and reputable online sources for more information, and empowering patients with the skills to evaluate the trustworthiness of online information,” Ngo told Healio.
For more information:
Summer Ngo, BS, can be reached at sungo@stanford.edu.
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