Evanagelista et al listed a number of signs that can help to identify a patient who may have a low health literacy. These patients can be targeted for a more formal assessment. The authors are from multiple institutions in the United States and the Heart Failure Society of America (HFSA).
Statements or actions that may indicate poor health literacy:
(1) forgot reading glasses
(2) cannot read because lighting is poor
(3) lifts the paper closer while reading
(4) points to words as reading
(5) will read instruction later
(6) needs someone to help read materials
(7) fails to follow instructions
(8) fails to keep appointments
(9) fails to get tests or to fill prescriptions
A more obvious indicator is someone who has little or no fluency in the language that instructions are written in.
A patient with one or more of these factors should have a more formal assessment to include literacy, vision, compliance, economics and other relevant factors.
