We are committed to improving health literacy as part of our mission to save and improve lives.
Health literacy is vital for health, be it living healthy, disease prevention or to achieve the best possible results from medical care. We must partner with patients to promote their understanding of their medical condition or disease, the reasons they are being treated, and the appropriate use of their medications and other treatments.
Health literacy is linked to literacy and entails people’s knowledge, motivation and competence to access, understand, appraise and apply health information in order to make judgments and take decisions in everyday life concerning health care, disease prevention and health promotion, to maintain or improve quality of life during the life course. Put simply, it is a person’s ability to obtain, communicate, process and understand health information.
Since its inception in 1891, our company has pushed the boundaries of science with the hope and expectation that advancing scientific knowledge will lead to major advances in health. Our commitment to improving patient health outcomes extends to our commitment to health literacy.
Health literacy can affect a person’s ability to access health care services, use services appropriately, adopt health-promoting behaviors, manage chronic conditions, navigate the health care system, and act on health-related news and information.1, 2
Health literacy challenges can affect people of all ages, races, incomes and educational levels. Some population groups in the U.S. are more vulnerable to low health literacy. They include the elderly, people with less than a high school education, people living in poverty, racial and ethnic minorities and people with limited English proficiency.
According to the World Health Organization (WHO), people with strong health literacy skills enjoy better health and well-being, while those with weaker skills tend to engage in riskier behavior and have poorer health. Patients require health literacy skills in order to understand and navigate the health care system, talk to providers, engage in self-management, exercise basic numeracy skills, adopt healthy behaviors and act on news and information. Self-management with the support of health care providers led to better outcomes in various chronic disease areas such as asthma, diabetes or arthritis.
We understand improving health literacy takes a multifaceted effort focused on public policy, engaging diverse stakeholders and new ways of communicating. We are calling government agencies, health care providers, patient advocacy groups and health care companies to work together to increase patient understanding of health care, health promotion and prevention and shared treatment plans.
Our internal efforts focus on improving internal awareness and the systematic adoption of health literacy.
Global external efforts were driven by a strong commitment to scientific excellence in health literacy. These efforts focused on several areas: patient support programs, evidence-based best practice sharing through presentations and publications and input to regulators about the importance of health literacy.
As a result of our external engagement, the MRCT working group will produce publicly available tools, resources and case studies to aid patient advocates, pharmaceutical companies and academic researchers in more consistently implementing health literacy during all phases of clinical research.
In addition, FDA draft guidance documents on PFDD have included health literacy references, and this has also been incorporated as a recurring theme in PhRMA and PFDD letters giving input on draft documents.
A cross-functional team of employees from medical affairs, marketing and sales participated in a day-long health-literacy training in China, culminating in the identification of a pilot project to advance patient communications.
Externally, MSD sponsored the 2018 Asia Health Literacy Conference and is working with patient advocates and scientific leaders to develop a manuscript highlighting health literacy activities across Asia.
In Australia, a team participated in a health-literacy webinar and performed a review of conference materials. The team is committed to expanding the inclusion of health literacy in future patient communications.
At the European Union level, the role of health literacy is recognized by high-level decision-making bodies. Both the conclusions of the Council of the European Union and the “Riga Roadmap”—a joint declaration by industry, civil society and patient organizations—refer to the importance of health literacy.3
Patients with higher health literacy levels are better able to navigate and access the health system, understand the importance of cancer prevention, seek earlier diagnosis and adhere better to treatment. Throughout 2018, we expanded our engagement to advance health literacy within the field of cancer. We supported the development of an eLearning Module about Health Technology Assessment (HTA) of the European Cancer Patient Coalition that aims to improve patients’ knowledge about HTA.
We believe health literacy is a key determinant for health. That is why we engage publicly and together with multiple stakeholders on health literacy and share best practices in national and global forums. In 2018, we have submitted a publication with the European Patients’ Forum (EFP), the European doctors (CPME) and the Global Health Literacy Academy and have begun six publications about health literacy in several disease areas, as well as broader regional perspectives.
We continue to actively engage throughout Europe to improve patient understanding of medicine, advocating for health literacy in e-labeling.
MSD in Belgium crowdsourced “HealthNest,” a coaching program to help health professionals, patient associations and others address their needs and gaps, such as creating a business plan.
In France, MSD was the first pharmaceutical company to support “University of Patients.” The region also partnered with patients and providers to support women’s empowerment and HPV prevention and launched an online platform about HPV.
MSD in Germany is supporting a coalition for patient safety; participating in a working group for user-friendly, digital Patient Information Leaflets and supporting 80 patient organizations on projects to improve health literacy in cancer, HIV, Hepatitis C, and other diseases.
In support of the National Action Plan to Eliminate Hepatitis C, MSD partnered with providers and launched “Don’t be late” to improve awareness of cervical cancer and also supported several patient associations in their efforts to improve health literacy.
Under the leadership of MSD, a pharmaceutical manufacturing group is addressing health literacy through health literacy awards and delivering an Academy for Patient Organizations, serving over 60 organizations since its launch in 2018.
MSD Ireland conducted research showing a significant lack of public trust in online health information and published and shared these results broadly.
MSD Italy has addressed health literacy in several ways, including two HPV awareness projects, the development of an online portal to provide trusted information about cancer and a patients’ digital health award.
Since 2009, MSD Poland has been organizing educational programs on HPV and cervical cancer, reaching more than 1,200,000 students since launch and 60,000 students in 2018 alone. They launched short articles, videos and infographics about the value of vaccines.
Throughout 2018, MSD Portugal partnered with several organizations to launch a website about several types of cancer and immunotherapy, providing practical guides to improve the quality of life for cancer patients.
MSD Slovakia created a “Map of Prevention,” highlighting key activities to promote prevention then convening multi-stakeholder working group to address the important issues. The Ministry of Health announced 2019 the Year of Prevention including cancer screenings.
MSD Spain has launched several initiatives to support health literacy and informed patients, including vaccine awareness, quality of life for cancer patients, diabetes and HIV.
In Latin America, Global Medical Affairs developed consumer materials about anesthesia and antimicrobial resistance, publishing 12 principles to remember before starting an antibiotic. These materials integrated health-literacy principles. Externally, MSD is working with patient advocates and scientific leaders in health literacy to develop a manuscript highlighting health-literacy activities across Latin America.
In the United States, we continue to focus on training our global workforce in health literacy. To date, over 1,000 employees have undergone training, including over 700 people in our clinical research organization.
As a result, there are many examples of health literacy in action across our company’s product lifecycle, including our earliest clinical trials, informed consent, diversity in trials, patient labeling, instructions for use, packaging and patient education.
The FDA approved our sixth health literate patient label developed with iterative patient input, and we were recognized as the second runner-up for the Healthcare Compliance Packaging Council’s “package of the year” for our antiviral medicine used to help prevent cytomegalovirus (CMV) infection after a stem cell (bone marrow) transplant from a donor.
In 2018, our product labeling team developed a Standard Operating Process (SOP) for new molecules, and currently human health marketing is developing a process to integrate health literacy principles into all new or updated patient materials.
Our clinical safety and risk management/pharmacovigilance teams have established goals to ensure that employees have a foundational understanding of health literacy to support communication of patient safety information. Beginning in 2019, new clinical trials included teach-back and cultural competence as part of their investigator training.
External efforts focus on sharing best practices including:
- Co-chair of Health Literacy in Clinical Research working group at the Multi-Regional Clinical Trials (MRCT) Center of Brigham and Women’s Hospital and Harvard
- Case study presentation (Patient Labeling) to the FDA as part of PhRMA working group input session on Patient Focused Drug Development (PFDD)
- Participant on BIO and PhRMA working groups on PFDD
- Planning committee for health literacy in clinical trials meeting of National Academies Health Literacy Roundtable
- Initiation of pharmaceutical collaborative of National Academies Health Literacy Roundtable
- Keynote panel at 2019 SCOPE meeting (Summit for Clinical Ops Executives)—over 1,800 attendees
- Keynote presentation at 2019 International Society for Medical Publication Professionals annual meeting—over 600 attendees
- Health Literacy Out Loud Podcast
|1 U.S. Department of Health and Human Services (HHS). Quick Guide to Health Literacy. Accessed June 22, 2016.|
2 HHS. Quick Guide to Health Literacy. Fact Sheet. Health Literacy. Basics. Accessed July 9, 2018.
3 The Riga Roadmap. Investing in Health and Wellbeing for All. (2015). Accessed May 13, 2016.