Limited Literacy Skills

Limited literacy skills are one of the strongest predictors of poor health outcomes for patients. Studies have shown that when patients have low reading fluency, they know less about their chronic diseases, they are worse at managing their care, and they are less likely to take preventive measures for their health (Graham & Brookey, 2008). More importantly to this review, low literacy implies that these individuals are unable to read instructions on prescription drug labels to determine how, when and how much of the medication to take. According to Davis et al. (2006), patients with lower literacy levels had more difficulty understanding prescription label instructions and prescription warnings and precautions. Other studies showed that low

(2008) defines health numeracy as “the individual-level skills needed to understand and use quantitative health information, including basic computation skills, ability to use information in documents and non-text formats such as graphs, and ability to communicate orally." Golbeck, Ahlers-Schmidt, Paschal, and Dismuke (2005) conceptualized health numeracy as falling into four categories: basic (the ability to identify and understand numbers, as would be required to identify the dose on a prescription label), computational (the ability to perform arithmetical calculations, such as calculating the amount of insulin needed per kg of body weight), analytical (the ability to apply higher level reasoning to numerical information, such as required to interpret graphs and charts), and statistical (the ability to apply higher level biostatistical and analytical skills, such as required to analyze the results of a randomized clinical

Some of the studies may not have specifically explored accuracy in prescription label reading but rather medication adherence or medication compliance as it relates to prescription interpretation. Further, some of the studies were not specific to diabetes patients but rather chronic disease as a whole. This literature review elucidates many opportunities for research in the Bahamian population or more specifically diabetics in the Bahamas since not many studies have explored or addressed the aforementioned variables. Further, the issue of language barrier provided further incite to a specific issue of health literacy in the Bahamas as it relates to the Haitian population. Deductive reasoning based on the literature assumes that Haitians whose native language is Creole may have difficulty understanding and interpreting prescription label. Data on this matter is limited and this presents an area of more in depth investigation in our study and can possible reveal an opportunity for Bahamian pharmacists to further improve medication self-management in a specific diabetic population. The review also revealed that pharmacy specific labelling style may be an additional determinant to label comprehension, and this factor must be taken into