Analysis of patient information leaflets provided by a district general hospital by the Flesch and Flesch-Kincaid method

Introduction: Patient information leaflets (PILs) remain the most frequently used sources of medical information. There is a concern that the reading age of these leaflets may exceed patient comprehension, thus negating their beneficial effect. The ‘Flesch Reading Ease’ and the ‘Flesch–Kincaid grade level’ are established methods for providing reliable and reproducible scores of readability. Method: All available hospital PILs (171) were assessed and divided into 21 departments. Microsoft Word was used to provide Flesch and Flesch–Kincaid readability statistics and compared against the national reading age and the recommended level for provision of medical information. Results: The average Flesch readability of all of the hospital’s PILs is 60, with a Flesch–Kincaid grade of 7.8 (12–13 years old). There is considerable variation in the average readability between departments (Flesch readability 43.8–76.9, Flesch–Kincaid 5.4–10.2). The average scores of two departments have PILs scores suitable for patient information. Conclusion: Although our PILs were well laid out and easy to read, the majority would have exceeded patient comprehension. The current advice for provision of NHS information does not highlight the importance of a recommended reading level when designing a PIL. Potentially a wide group of patients are being excluded from the benefits of a PIL.