Associations of an Easy-to-Understand Patient Letter on the Health Literacy of Patients after Discharge from Hospital: Results of a Randomized Controlled Intervention Study

Background 54% of the German population has limited health literacy, which is associated with poorer health outcomes and higher utilization of the healthcare system.Aim of the study The aim of this pilot study was to examine the effects of an easy-to-understand patient letter on patients' health literacy after discharge from a Clinic for Internal Medicine and to analyze patients' need for written, easy-to-understand information.Method In a randomized controlled trial (2016-2018), the effects of the patient letter on health literacy were examined by means of the HLS-EU-Q47 questionnaire. The intervention group (IG, n=242) received an easy-to-understand patient letter 3 days after discharge, the control group (KG, n=175) received only the usual medical discharge letter.Results 60% of post-discharge patients were found to have limited health literacy. The study could not show any effect of patient letters on overall health literacy. The analysis of single items of health literacy showed positive effects of these letters on patients' comprehension of medical advice as well as their understanding and implementation of medication instructions (Cohens d=0.20). Furthermore, patients expressed their wish for information after discharge from hospital (99%) and rated the patient letter as informative, understandable and helpful.Conclusions Patients wish to receive and are empowered by an easy-to-understand letter after discharge from hospital with medical information and medical instructions that they can implement at home.