Readability and content of supplementary written drug information for patients used by Australian rheumatologists

Objective: To determine the readability and content of supplementary written drug information currently being given to patients by rheumatologists in Australia. Design and participants: Blinded standardised review by two independent reviewers of supplementary written drug information routinely provided to patients by the 195 fully registered members of the Australian Rheumatology Association (ARA). Main outcome measures: FOG and SMOG readability scores to estimate readability; critical appraisal of content according to predetermined criteria. Results: 84 rheumatologists responded (43%), 45 of whom reported providing copies of written drug information to patients. Overall, 91 different documents were reviewed. Drugs most commonly considered were methotrexate (17), gold (16), sulfasalazine (10), penicillamine (10) and prednisolone (8). Level of agreement between reviewers for FOG and SMOG scores was fair to good (intraclass correlation coefficient, 0.61 and 0.51, respectively). Mean (95% CI) FOG and SMOG scores were 12.6 (12.2-12.9) and 11 (10.7-11.2), respectively (implying that half of those in Year 12 [or aged 17 years] and Year 11 [or aged 16 years] according to the FOG and SMOG mean scores, respectively, will comprehend half of the text or more). For the same medication, there was a wide variation in the information provided, including which side effects were discussed. While 98% included some information about side effects, fewer considered dose (74%), drug interactions if applicable (70%), purpose of drug (67%), how and when to take the drug (62%), expected time to improvement (54%), what to do in the event of side effects (44%), the expected duration of therapy (18%) and what to do if a dose was missed (5%). Conclusions: The reading level required to understand supplementary written drug information used by Australian rheumatologists is much higher than the average reading ability of the Australian population (estimated at Year 8 level). The content of this information varies widely and often omits important information.