A year on after writing our project report on ‘making the case for evidence-based patient information’ the importance of evidence-based information has never been more vital. Health hasn’t been just the primary concern for health and care professionals or those individuals with health conditions, it has been the predominant topic for everybody globally.
The coronavirus pandemic (Covid-19) has created, what has felt like, a new industry of information for us all to consume, digest and understand in order for us to go about our daily lives. From following the current guidance to implementing changes to our libraries so we can re-open safely. We also have a role in supporting others in providing accurate and updated information on various aspects of Covid-19 too, to help give trustworthy information to inform their own health decisions and even simple day to day actions such as travel and socialising
The findings of our project report remain as relevant now as they did when we published it;
 Evidence-based health information makes a positive contribution to the health care system. The last few months has been a time of uncertainty, creating a sense of fear and anxiety for many of us. It has been challenging to keep track of the various channels of communication to identify authoritative information as well as shining a light on ‘fake news’ about Covid-19. When headlines citing ways of avoiding getting Covid-19 ‘through eating garlic’ or the assumption ‘only older people are susceptible’ to this infection, it provides for a confusing and potentially dangerous information landscape. Engaging our critical appraisal skills can help give others the reassurance needed to locate the most appropriate information or evidence they can understand and feel confident in its accuracy.
 The need for evidence-based health information is aligned with a number of high-level strategic priorities which support shared decision-making.The Health information Week web site for 2020’s campaign listed some useful questions to consider when looking at health information, including a number of resources that can be downloaded and adapted for local use. The new NHS LKS web pages signposting members of the public to health information as well as included information and resources about Coronavirus which are easy to understand and accessible online for patients and the public alike.
 Library and Knowledge Services have a key role to play in influencing how health information is produced and delivered within local trusts. Since writing our report there has been a new UK-wide quality standard developed by the Patient Information Forum, TICK which can help us guide others in what they must do in order to provide robust and accurate patient information, one of the components being that it must be evidence based, to further make the case for this and highlight the contribution we can make.
 Sharing learning and experience across our networks – throughout the last few months NHS Library and Knowledge Services have demonstrated the benefits of sharing resources on Covid-19. Literature searches and lists of resources have been made widely available by local services so others can tap into more tailored and topics-specific information to support health and care professionals manage the tsunami of Covid-19 related information.
It would be good to hear examples of where NHS LKS have supported patients either directly or through those providing information to patients virtually during the pandemic.
How do we capture new learning and break down some of physical barriers highlighted in our report?
Health Information Week is a national, multi-sector campaign to promote high quality information for patients and the public. High quality health information can have a huge impact on people’s ability to stay healthy and manage illnesses effectively, giving them a better quality of life. This year, #HIW2020 runs from Monday 6th to Sunday 12th July.
Are you interested in being involved in #HIW2020 but not sure where to start? Or maybe you’ve been involved for a number of years and you’re looking for something different to do this year? Perhaps you don’t feel you have the resources to do much? Alternatively maybe you’d like to do make #HIW2020 a really significant part of your outreach work this year? The good news is that you can spend as much or as little time as you have on #HIW2020, from running a week long programme of events to simply retweeting posts from @HealthInfoWeek.
The Ideas Bank is a great place to start. It includes all the ideas from previous years, and we’ve recently updated it to include new ideas from #HIW2019 activities run by different teams from across the country. Maybe a walkabout to key teams would be more effective than a display? Maybe you can ask a health professional to present at a public library or other public venue?
Tips for making contact with teams in your local
area who may be interested in working with you, both inside and outside your
Ideas for teams with limited time and resources
Fun ideas to draw a crowd
And if you have other ideas, please let us know – other people may find them really useful too. Email us on Healthinfoweek@gmail.com or Tweet us on @HealthInfoWeek
Your organisation’s Covid-19 response may affect the planning you can do at this stage. Dependent on how things develop, it may also affect what is possible during #HIW2020 itself. Follow national guidance, and also your local guidance. Some of the things in the Ideas Bank would not be appropriate during current precautions – they are included in hope that by Monday 6th July, they will once again be safe. Other things, such as social media use, can continue as usual during Covid-19.
People of all ages, backgrounds, and education levels need health information, but often find it difficult to find and understand. Low literacy levels, in terms of reading, and being able to find, understand, and apply information, are a barrier to successful patient participation, and this is problematic, given the increasing recognition about the importance of engaging patients in the treatment decision-making process.
Health literacy and health information literacy are phrases that are becoming more widely used, sometimes interchangeably. However, there is a difference, and this post hopes to clarify the meaning of each.
Health literacy is the ability to understand instructions provided by health professionals. “In England, 42% of working-age adults are unable to understand and make use of everyday health information, rising to 61% when numeracy skills are also required for comprehension” (1), and “around one in five adults cannot read or understand simple instructions or labels such as those found on medicine bottles” (2, 3). The inability to read can result in patients taking medicines at the wrong times, not following dosages correctly, or not understanding instructions properly (4). For example, if the label on the prescription says “Take three tablets daily”, does this mean take three tablets at the same time or take one tablet three times a day? The quote in the box below, comes from a Facebook post written by a surgeon, and perfectly illustrates the consequences of misunderstanding medical instructions.
Health information literacy
Health information literacy, although often referred to as health literacy, has a more in-depth scope. It is not only about access to the Internet and online health information, but also about having the skills required by people to effectively recognise:
· what they need to know about their condition and treatment options,
· how to find that information, to fill those knowledge gaps,
· how to appraise the information to ensure it is good quality, and relevant to their personal context, and then
· how to use the information with their health professionals so that they can make an informed decision that suits their needs (5, 6).
Poor health information literacy can result in poorer health outcomes, unhealthy lifestyles, increased incidence of chronic conditions and mortality, greater use of emergency services, and increased hospital stays (1, 7-13).
Role of librarians
Maimonides, a Spanish philosopher said “Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.” This quote reflects the importance of health information literacy, because if you find the information for the patient, their query will be satisfied, but if you teach them to search and appraise, they will be able to make informed decisions throughout their care pathways.
Health information literacy is an area where librarians, from all sectors, whether medical, public or academic, are in a strong position to support. They already have the resources, skills, and processes in place (14). Librarians can signpost people to the best sources, and teach them to search, retrieve, and appraise what they find (15). Medical librarians have the skills associated with evidence-based practice, as it is embedded in their roles, their primary function being teaching health professionals how to find and appraise the evidence. They also have access to the
relevant information sources, while public and school librarians are a trusted source within their communities, and understand the local context. Working in partnership would improve access to good quality health information at a location accessible to local people, who most likely would not have access to medical libraries.
People benefit from having access to good quality health information because it enables them to make informed decisions and follow their treatment regimens more effectively and safely (16-18). Informed patients are more likely to comply with the treatment regime, resulting in improved health, and reduced length of stay, and hospital admissions. Since the average doctor’s visit in England lasts 8-10 minutes (19), patients need to be ready to ask the right questions. Helping patients to self-manage by improving their health information literacy skills will benefit both the patient and the health system (1, 20, 21). By improving access to clear, current, accurate, and understandable consumer health information, health inequalities can be reduced and patients will feel more empowered (1, 22).
Creating health information literacy support programmes and resources is a new area for medical, public, and school libraries to work and lead on together. Library communities would benefit, in terms of professional development, more efficient working practices, and demonstrating value to the community. Patients could see improved health outcomes and better quality of life, health, and wellbeing, while health services might see a reduction in health service utilisation.
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