Improving Health Literacy of Antifungal Use - Comparison of the Readability of Antifungal Medicines Information from Australia, EU, UK and US of 16 antifungal agents across five classes (allylamines, azoles, echinocandins, polyenes, others).

Adherence to antifungals is poor in high endemic regions where antifungal resistance is high. Poor readabilty of prescription/over-the-counter (OTC) antifungals may contribute to poor adherence, due to the patient not fully understanding the purpose, importance and dosage of their antifungal medicine. As there are no reports on the readability of antifungals, this study examined the readability of patient-facing antifungal information. Antifungals [n = 16; five classes (allylamines, azoles, echinocandins, polyenes, others (flucytosine,griseofulvin))] were selected. Readability of four sources of information, (i) summary of product characteristics (SPC), (ii) patient information leaflets (PILs), (iii) over-the-counter (OTC) patient information and (iv) patient web-based information, was calculated using Readable software, to obtain readability scores [(i) Flesch Reading Ease (FRE), (ii) Flesch-Kinkaid Grade Level (FKGL), (iii) Gunning Fog Index and (iv) SMOG Index] and text metrics [word count, sentence count, words/sentence and syllables/word]. PILs, web-based resources and OTC patient information had good readability (FRE mean ± sd = 52.8 ± 6.7, 58.6 ± 6.9, 57.3 ± 7.4, respectively), just falling short of the ≥ 60 target. For FKGL (target ≤ 8.0), PILs, web-based resources and OTC patient information also had good readability (mean ± sd = 8.5 ± 1.0, 7.2 ± 0.86, 7.8 ± 0.1, respectively). Improved readability scores observed correlate with reduced words, words/sentence and syllables/word. Improving readability may lead to improved patient health literacy. Healthcare professionals, academics and publishers preparing written materials regarding antifungals for the lay/patient community are encouraged to employ readability calculators to check the readability of their work, so that the final material is within recommended readability reference parameters, to support the health literacy of their patients/readers.