Evaluating the readability and comprehension of patient education materials for Systemic Lupus Erythematosus (SLE) available online

Abstract

Objective

We evaluated the reading & comprehension levels of Systemic Lupus Erythematosus (SLE) Patient educational materials (PEMs) available online, from both nonprofit and for-profit organizations.

Methods

We analyzed PEMs from four nonprofit organizations (American College of Rheumatology [ACR], Lupus Foundation of America [LFA], Lupus Research Alliance [LRA], Lupus Society of Illinois [LSI]) & three for-profit company’s platforms (Aurinia, AstraZeneca, GlaxoSmithKline [GSK]). Reading & comprehension scores were calculated using six standard tools, and comparisons were performed using one-way ANOVA & Tukey’s post-hoc analysis. A p-value ≤0.05 was considered statistically significant.

Results

The average Flesch–Kincaid Grade Level (FKGL) and Flesch Reading Ease Score (FRES) across all PEMs were 10.05 ± 0.70 and 52.68 ± 4.10, respectively. Materials from nonprofit organizations had a FKGL of 10.35 ± 0.88 and a FRES of 51.19 ± 4.91, indicating a reading level requiring 10th- to 12th-grade proficiency. For-profit organizations had a slightly lower FKGL of 9.98 ± 0.42 and a higher FRES of 54.35 ± 2.65. These differences were not statistically significant (p = 0.53 and 0.16). However, significant within-group differences were observed. Among nonprofits, PEMs from LFA had the most favorable readability metrics (FKGL 9.19 ± 0.44, FRES 58.34 ± 3.11), compared to ACR (10.64 ± 0.56, 49.81 ± 2.24), LRA (10.53 ± 0.61, 50.54 ± 2.69), and LSI (11.28 ± 0.45, 45.64 ± 2.03) (p < 0.01). Among for-profits, PEMs from Aurinia had significantly better readability scores (FKGL 9.59 ± 0.46, FRES 55.77 ± 3.05) than those from AstraZeneca (9.93 ± 0.38, 53.13 ± 2.48) and GSK (9.86 ± 0.25, 54.28 ± 2.16) (p < 0.001).

Conclusion

Most SLE patient education materials available online are written at or above a 10th-grade level. These findings highlight the urgent need to improve PEM readability to support patients with lower health literacy.

Keywords

health literacy patient-centered care patient education materials reading and comprehension systemic lupus erythematosus

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