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The purpose of this study was to examine the relationship between health literacy and health-related quality of life (HRQOL) in a sample of English-speaking Tennesseans attending a university-based family medicine residency clinic. We measured the health literacy skills of patients (n = 249) using the Rapid Estimate of Adult Literacy in Medicine (REALM), dividing patients' scores into limited (< or = 8th-grade level) and adequate (> or = 9th-grade) literacy skill levels. We measured HRQOL using four items developed and validated by the Centers for Disease Control and Prevention (CDC). Scores on the REALM indicated that 28.5 percent of patients had limited and 71.5 percent had adequate health literacy skills. There was a significant correlation between patients' health literacy skills and self-reported general health (rho = 0.249, P < 0.01). Patients with limited health literacy skills had a higher median number of physically unhealthy days (P = 0.05) and activity limitation days (P = 0.05) compared with patients with adequate health literacy skills. Based on this study, patients' health literacy skills are associated with several components of HRQOL.

Purpose: The suitability, readability, and cultural appropriateness of written supplemental materials available on the Internet for nonprescription medications were examined., Methods: We videotaped 48 hours of television programming, recording a total of 152 advertisements highlighting 37 unique nonprescription medications. The supplemental materials corresponding to each advertised medication were downloaded and printed in their entirety from each product-specific Web site. These materials were assessed using the Suitability Assessment of Materials (SAM) instrument. Total SAM scores were grouped as follows: not suitable (0-39%), adequate (40-69%), and superior (70-100%). The Fry readability formula was used to determine the reading grade level for the materials assessed with the SAM instrument., Results: The mean +/- S.D. SAM score of all materials was 54.9% +/- 0.1% (range, 38-76%). Materials for the majority of drugs (86.5%, n = 32) were rated adequate. Materials for four drugs (10.8%) were rated superior, and the material for one drug was not suitable. While the total SAM scores were adequate for most of the materials evaluated, the majority of materials scored particularly poorly for their reading level (the materials for 81.1% of drugs were not suitable). The materials for 40.9% of drugs used uncommon words., Conclusion: Evaluation of the suitability, readability, and cultural appropriateness of written supplemental materials for nonprescription medications available on manufacturer-sponsored Web sites and intended for consumers or patients revealed that SAM scores were adequate for most of the materials; however, many scored poorly in the areas of reading level and used uncommon words.