Using Printed Materials

Printed materials are the next most frequently used patient education modality after verbal instruction. Unfortunately, these materials are often used alone, or without sufficient preceding verbal instruction, as a surrogate for providerpatient interaction. Printed materials can be classified into two types: prescriptive and nonprescriptive. Although there is some overlap between the two, prescriptive materials are usually given by the provider to the patient with a specific goal in mind. Their use is often triggered by the onset or recurrence of a medical problem. For example, if the patient has strained the lower back muscles, a brochure may be given that explains back mechanics, avoidance measures to prevent repeat injury, and a physical program to improve flexibility and strength during and after healing. This material can supplement the physician's instructions about the care of this injury.

In contrast, nonprescriptive materials are put out for patients to take freely or read as desired, usually in a waiting room or examination room area. These materials are more general and topic oriented, serving as "general health education" rather than patient education. Examples include a brochure that describes the four basic food groups and a pamphlet that describes common sexually transmitted diseases. Although serving more to inform than to change behavior, nonprescriptive materials may lead to patient questions and expand opportunities for patient education during the office visit.

Physicians are responsible for the accuracy of any materials they distribute. Hundreds of materials are available free of charge or at low cost. Sources of such materials are primarily pharmaceutical companies, national voluntary associations (e.g., ACS, AHA), and medical specialty societies such as the AAFP and American Academy of Pediatrics (AAP). Several issues are important to consider before using existing materials. First, is the content appropriate? Materials provided by pharmaceutical companies may advertise a product or present information in a biased way. Voluntary organizations' guidelines may not agree with the physician's judgments about proper screening and treatment. Second, is the material clearly presented, with a reading comprehension level appropriate for the patients served by the practice? A third type of concern is logistical. Will additional copies of the material continue to be available for replenishing supplies, or will the material go out of print? This is particularly a concern for pharmaceutical-funded campaigns. Is the format of the material suitable for storage and display in whatever system is used in the practice?

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