1. Health Literacy views: The clinician viewpoint Barcelona. January 14 th , 2008 Joan Escarrabill MD Hospital Universitari de Bellvitge L’Hospitalet (Barcelona) [email_address]

3. Patient education 1980 2 vols 1853 pages

4. Patient Education Improves compliance Better Outcomes = = Compliance

6. Adherence & frequency of doses Osterberg L & Blaschke T. N Engl J Med. 2005;353:487-97.

7. Smoking habit in COPD patients Med Clin (Barc) 1989;93:772-4 of patients on LTOT were current smokers 27% Current smokers 23% Hernández. Eur Resp J 2003;21:58-6 . Hospital at home 26% Eur Respir J 2000;16:1037-42 EFRAM Study

8. Smoking & LTOT in Denmark 25.1% Ringbaek TJ, Lange P. Respir Med 2006; 100:218-25 Danish register Current smokers 21.1% NS 1994 2000

10. Coulter A. BMJ 1999;319:719-20 Paternalism is endemic in the NHS

11. LTOT prescriptions without ABG criteria 1984 1995 56% 40% Escarrabill. Lancet 1985:ii:779. Farrero. Arch Bronconeumol 1998;34:374-8 LTOT: compliance with guidelines LTOT Danish register 1994 65% Incorrect prescription 2005 LTOT < 15 h/day 65% Follow-up withdraw 33% Current smokers on LTOT 21% Ringbaek TJ & Lange P. Respir Med. 2006;100:218-25.

12. LTOT: Improvement of the survival through the time

13. JAMA 1998;279:1309 Provision of adequate context for new research results is one of the main problems in presenting medical and health news for the public. a tool for more effective communication between patients and physicians.

15. Health literacy vs poor communication

16. A powerful tool.... The pediatrician of my daughter typed systematically all the recommendations in an old typewriter

17. Health literacy Health Literacy Health Education The degree to which people have de capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

20. www.separ.es/ Public information about respiratory diseases

21. www.separ.es/ COPD

22. www.separ.es/ COPD

24. www.separ.es/ Sleep apnea

28. Tutor patient: development of the project 2 Definition of competences What competences should have the tutor patient to be able to teach other patients? 3 Asking the patients Interviews Focus groups

29. Tutor patient: development of the project Health professionals Tutor patient Patient Patient Patient Patient Patient Tutor patient Patient Patient Patient Patient Patient Tutor patient Patient Patient Patient Patient Patient

31. BMJ 2006;333:1143-5

32. www.patientslikeme.com/