Accuracy of healthcare professionals’ estimation of patient’s health literacy compared to a validated questionnaire in a secondary care setting in the UK: a cross-sectional study

BACKGROUND: Literacy is the ability to read, understand, and utilize information and to communicate through verbal and written communication. Health literacy applies these skills in a healthcare context. Healthcare professionals' (HCP) perceptions of patients' health literacy levels are crucial to allow delivery of information in a clear and accessible manner. METHODS: This was a cross-sectional study in secondary care with opportunistic recruitment of HCPs and patients. Patients completed a demographic questionnaire and the Medical Term Recognition Test (METER), a validated measure of functional health literacy. HCPs provided an estimation of the patient's health literacy after their care interaction. Comparisons between METER results and HCP estimations were made to assess HCPs' estimations accuracy. RESULTS: Health literacy was assessed for 142 patients. Of the 220 estimations by HCPs, 55.5% were correct. Consultants had the highest accuracy (70%). Other HCP groups' accuracy ranged between 44.7% and 55.8%. The intraclass correlation coefficient (ICC) assessed the agreement between HCPs' estimations and patient's health literacy, revealing poor agreement (ICC = 0.2; CI = 0.074, 0.327; P = .00117). CONCLUSIONS: This reveals disparities between HCPs' estimation and METER-assessed functional health literacy. Addressing this gap is crucial in allowing HCPs to provide more tailored communication to empower patients in decision-making.