Researchers from three disciplines at Duquesne University – Speech-Language Pathology, Occupational Therapy, and Nursing – studied the effects of simplifying written instructions for medications in contrasting groups of persons with aphasia (PWA) and persons without aphasia (PWoA). The goal was to answer three questions. 1. What are the group comprehension differences between PWA ~ PWoA when using unmodified medication instructions? 2. What are the group differences when such instructions are simplified? 3. Which of the instruction sets do the study participants prefer?
Two groups – one comprising 9 PWA, and the other – 9 PWoA – were recruited. The groups were broadly comparable, for example showing mean age of ~ 61 y, and educational levels between 12-18 years. The PWA ranged in diagnostic categories from mild anomia to global aphasia. Members of each group were given first unmodified information about medications to read, after which they answered 8 multiple-choice questions to probe comprehension. Next, the process was repeated with a set of simplified instructions, followed by questions. Finally, participants indicated which instruction set they preferred.
Unmodified, the directions looked like those that come with prescription medications from pharmacies. The text was dense, in small typeface, and it fully covered one side of a sheet of paper. The sentences were ~25 words in length, included medical terminology, and had no illustrative images. These materials required reading skills at roughly college freshman level. The simplified instructions were presented in larger typeface, generously spaced, used only simple syntax and non-technical vocabulary, with around 8 words per sentence. Illustrative images were included. The information took up around 9 pages, with reading skills at roughly middle school entry level.
Results show that when the instructions were simplified, comprehension among PWA improved significantly, while among PWoA only a small and statistically insignificant improvement was noted. As might be expected, the PWoA invariably demonstrated better comprehension than the PWA, regardless of condition. Nonethless, in both of the groups most participants expressed a preference for the simplified instructions over the unmodified ones. Given these findings, it seems advisable to consider developing mechanisms for providing simplified instructions to recipients of medications generally, upon request
For further reading: A. Saylor, S. E. Wallace, E. D. Brown, et al., 2022, Aphasia-friendly medication instructions: effects on comprehension in persons with and without aphasia. Aphasiology, 36(3): 251–267, https://doi.org/10.1080/02687038.2021.1873907