Bridging the health literacy gap: a review on evidence based patient information sheet

Abstract

Health literacy strongly influences the degree to which patients understand their health information, stick to treatment plans, and achieve better clinical outcomes. While patient-centered communication is widely valued in healthcare, many current patient information sheets are written above the reading level of most adults, which can reduce informed choices and make it harder for patients to follow treatment plans. This review brings together current evidence exploring methods for composing patient information that people can understand. It uses well known models and recent research studies to point out the key features of clear materials and reduce gaps in health literacy. A narrative synthesis based on studies found in PubMed, Scopus, and Google Scholar and reviewed English-language articles published from 2005 to 2025 that examined readability, design choices, and how well patients understand educational materials and reviewed both empirical studies and systematic reviews in four themes: layout and formatting, simplifying language, visual communication, and validating readability. Research showed that close to half of adults worldwide have limited health literacy. At the same time, many patient education materials are written above an 11th-grade reading level, which is higher than the sixth to eighth-grade level usually recommended. The results suggest that a clear layout, sans-serif fonts, enough white space, and information presented in a sensible sequence reduce readers’ mental effort and make the content easier to understand. Plain language steps, like writing sentences that are about 15–20 words long, using active voice, and cutting medical jargon, can help people with low literacy understand health information more easily. Using visual aids that match the local culture may increase comprehension in these groups by up to 40%. Using established readability tools in a consistent way, and then confirming the results through user testing with the intended audience, helps ensure that the materials meet both ethical expectations and practical accessibility needs. Using evidence-based design principles set by expert committees is an ethical duty because it supports patient autonomy, clear informed consent and fair healthcare for people with different literacy levels.