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dc.contributor.authorPhua, Chuen Yenen_US
dc.contributor.authorZheng, Lifengen_US
dc.contributor.authorTan, Ngiap Chuanen_US
dc.contributor.authorTang, Wern Eeen_US
dc.contributor.authorSmith, Helen Elizabethen_US
dc.identifier.citationPhua, C. Y., Zheng, L., Tan, N. C., Tang, W. E., & Smith, H. E. (2020). Review of the quality of printed patient education materials on asthma available in primary care in Singapore. Journal of Asthma, 57(7), 787-798. doi:10.1080/02770903.2019.1602876en_US
dc.description.abstractObjective: Patient education materials (PEMs) are commonly used for patient education. This study assessed readability, format quality, accuracy, understandability and actionability of printed asthma PEMs available in primary care in Singapore. Methods: Primary care in Singapore is provided by island-wide polyclinics and private general practices. We invited the three polyclinic healthcare groups and private general practices via the Primary Care Research Network to submit asthma-related PEMs. Readability was assessed using Simple Measure of Gobbledegook (SMOG) and Flesch–Kincaid (FK) score. Format quality was assessed using “Clear-print and large-print golden rules” from UK Association for Accessible Formats (UKAAF). Understandability and actionability were evaluated using Patient Education Materials Assessment Tool – Printed. Three pulmonologists assessed content accuracy. Results: Thirty leaflets were assessed. SMOG and FK estimated 93% (mean 9.3, range 5–14, SD 1.8) and 47% (mean 6.8, range 2.4–9.9, SD 2.0) exceeded the recommended sixth-grade reading level, respectively. About a third (37%) were fully concordant with UKAAF guidelines, with poor format quality contributed by small font size, poor text emphasis methods, and not using left-aligned text. Leaflets generally scored well in both understandability (mean 84%) and actionability (mean 72%). Thirteen leaflets were inaccurate, 92% of which contained at least one inaccuracy judged to have potentially harmful consequences to patients, including wrong emergency advice. Conclusion: While understandability and actionability are adequate, current asthma PEMs are limited by inappropriately high reading levels, poor format quality and inaccuracies. Healthcare professionals need to assess patients’ reading abilities and ensure PEMs are accurate and suitable for their patients.en_US
dc.description.sponsorshipMinistry of Health (MOH)en_US
dc.description.sponsorshipNational Medical Research Council (NMRC)en_US
dc.relation.ispartofJournal of Asthmaen_US
dc.rightsThis is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Asthma on 06 May 2019, available online:
dc.titleReview of the quality of printed patient education materials on asthma available in primary care in Singaporeen_US
dc.typeJournal Articleen
dc.contributor.schoolLee Kong Chian School of Medicine (LKCMedicine)en_US
dc.description.versionAccepted versionen_US
dc.subject.keywordsPatient Educationen_US
dc.description.acknowledgementThis research is supported by the Singapore Ministry of Health’s National Medical Research Council under the Centre Grant Programme (Ref No: NMRC/CG/C019/2017).en_US
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