Chronic diseases, such as diabetes, exact an enormous cost on health systems worldwide. While diet, exercise, and medication can enhance outcomes, poor management inevitably causes serious complications. Unfortunately, non-compliance with medication and lifestyle directives is common (Kessels 2003; Urquhart 1996) and improving patient compliance remains a significant challenge for our medical system.
The quality of communication between doctor and patient (Kerse et al. 2004) and how well patients comprehend treatment information (Kessels 2003) are major determinants of compliance. This is unsurprising given that retention of instructions typically requires comprehension. Patients will most effectively comply with instructions that they remember, following a consultation (Wasson 1979). Unfortunately, many doctors struggle to communicate adequately with patients for a variety of reasons. These include time available, and the difficulty of simplifying highly technical concepts (Larsson 1987). Moreover, patients often fail to grasp the importance of the behaviors described in the treatment plan or lack motivation to adhere for an extended period (Marshall and Maiman 1980).
Studies in social psychology and education indicate that people take notice of and remember information that is easy to read, emphasizes personally relevant issues, and is structured to fit the individual’s cognitive style (Cameron 2009; Evans 2008). Personal relevance is also associated with persuasion, in that arguments that appeal to an individual’s values are the most persuasive (Roser 1990).
These principles are the basis for message tailoring in mass-marketing campaigns to ensure coverage of as many market segments as possible (Novak and Hoffman 2008). For example, anti-smoking health campaigns often use both a story-telling approach and a more scientific fact-based argument. These principles are also relevant for individual communication between doctor and patient, but are unlikely to be considered. Consequently, when a patient with diabetes goes to see his or her doctor the material shared with the patient is typically expressed as numeric results, such as “HbA1c 8.5, previous test 8.3” The doctor translates this information into diet and lifestyle advice for the patient. Unfortunately, there are no defined tools for tailoring this information to fit an individual patient’s information processing style or emphasize personally important issues.
Developing more effective ways to present pathology reports is important because commonly used formats are often confusing to patients, and misunderstanding of reports can lead to negative outcomes for them. Currently used formats do not give doctors any options to customise the information according to their assessment of the patient’s needs. Thus doctors currently have no effective tools to assist them in giving important information to patients and their families. This leads to a lack of understanding of both the condition and treatment requirements (Powsner et al. 2000; Vahabi 2007). Patients who understand their medical conditions better are more likely to manage those conditions better (Marshall and Maiman 1980; Vermeire et al. 2001).
The project was initiated in consultation with relevant medical practitioners and consumers who saw a need for new ways to present pathology information so that it could be understandable, meaningful and significant for a wide range of consumers including those from a range of culturally and linguistically diverse groups.