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Academy · Research Writing · Patient education materials
Writing patient education materials that change adherence
Most patient materials are accurate, complete and unread. The gap between a leaflet that is correct and one that changes what a patient does is mostly structural, and the structure is measurable before anyone prints it.
Reading level is the floor, not the goal
The usual advice is to write at a sixth- to eighth-grade level, and it is sound as far as it goes. Health literacy surveys across several countries have repeatedly found a substantial share of adults functioning below the level at which typical health materials are written, and the mismatch is worse for people managing more than one condition.
But a readability score measures sentence length and syllable count, which is why a document can score well and still be unusable. “Take as directed” scores beautifully and tells a patient nothing. Treat the score as a check you must pass, not as the thing you are optimising.
What the score misses
Whether the action is findable. Whether the reader can tell which part applies to them. Whether the first thing on the page is the thing they came for. Readability formulas measure none of these, and all three matter more.
Put the action first
Most leaflets are organised the way a clinician thinks: what the condition is, why it happens, how it is diagnosed, how it is treated, what to watch for. The patient is reading to find out what to do this evening, and the answer is on page three.
Invert it. Open with the action — what to take, when, what to do if something happens — and put the explanation underneath for the reader who wants it. This single change does more for adherence than any amount of simplification, because it puts the instruction where a reader who stops after thirty seconds will still see it.
What to cut
- Background that does not change behaviour. The mechanism of the drug is interesting; it rarely alters whether the patient takes it.
- Complete side-effect lists. An undifferentiated list of thirty effects tells a patient nothing about what is common and what is urgent. Group them: what is expected, what to report, what to act on immediately.
- Conditional branches that do not apply. A leaflet covering four dosing scenarios makes every reader do the sorting. Where possible, produce the version that matches the patient.
- Hedged clinical caution. “May cause” on every line flattens everything to the same weight. Say what is common and what is rare in plain frequencies 2.
Numbers patients can use
Risk communication research has converged on a few practical rules. Use natural frequencies rather than percentages &mdash 3; “about 1 in 10 people” is understood more reliably than “10%”, and far more reliably than a relative risk. Keep the denominator the same across comparisons. And give both the benefit and the harm in the same format; presenting benefit as relative and harm as absolute is a well-documented way of making a treatment look better than it is.
Where a number is genuinely uncertain, say so in words rather than adding a confidence interval a patient cannot use.
Test it on the people who will read it
The step almost always skipped. Give the draft to five or six patients or carers from the intended group and ask them three questions: what should you do tomorrow, what would make you call us, and was there anything you could not follow. You will find problems no readability tool detects — a word that means something different locally, an instruction that assumes a routine the reader does not have.
For regulated materials this testing may be formally required. The European readability guideline sets out user testing expectations for package leaflets, and where a document falls under it the testing is a compliance step rather than good practice 1.
What we can and cannot do here
We write, restructure and plain-language edit patient materials, and we run readability and structure checks against the standard that applies to your document. What we do not do is approve them. Where a leaflet falls under a regulated review process, the medical, legal and regulatory sign-off belongs to the sponsor’s own qualified staff — we can prepare the pack that goes into that review, but we cannot be the reviewer.
Take-home message for authors and researchers
- Put the action first and the explanation underneath; it does more for adherence than any amount of simplification.
- Use natural frequencies, keep the denominator constant, and give benefit and harm in the same format.
- Group side effects by what to expect, what to report and what to act on immediately.
- Test the draft on five or six people from the intended group before it is printed.
Common questions
Any of the common ones will identify a document that is too dense; they disagree at the margins, so pick one, state which you used, and do not tune the text to the formula. Whichever you choose, the user test matters more.
Short enough that the action is visible without scrolling or turning a page. Where more detail is genuinely needed, a short front page with a longer section behind it works better than one long document.
Where they show an action — how to use an inhaler, where to inject — yes, and they often outperform text. Decorative images add length without adding meaning. Any image showing a device should match the device the patient actually has.
Yes. A translation that is linguistically accurate can still fail on structure, idiom and cultural assumptions, and back-translation checks meaning rather than usability.
The sponsor’s own medical, legal and regulatory reviewers, or the equivalent governance in your organisation. We prepare the document and the supporting pack; the approval sits with them.
References and sources
- European Commission guideline on the readability of the label and package leaflet for medicinal products. read 11 September 2026. health.ec.europa.eu/medicinal-products/eudralex/eudralex-volume-2_en
- Plain language guidance and health literacy resources, US Centers for Disease Control and Prevention. read 11 September 2026. www.cdc.gov/health-literacy/php/toolkit/index.html
- Cochrane review evidence on presenting risk as natural frequencies. read 18 September 2026. www.cochranelibrary.com
Each source carries the date it was last read. Where a standard moves, this article is revised rather than left up with a note.
How to cite this article
Pick your referencing style and copy it. Your university or target journal may vary the punctuation — check its guide if it has one.
Pubrica Academy. (2026, February 18). Writing patient education materials that change adherence. Pubrica. https://pubrica.com/insights/how-physicians-can-write-clear-and-impactful-patient-education-materials/
Pubrica Academy. “Writing Patient Education Materials that Change Adherence.” Pubrica, 18 Feb. 2026, pubrica.com/insights/how-physicians-can-write-clear-and-impactful-patient-education-materials/.
Pubrica Academy (2026) Writing patient education materials that change adherence. Pubrica. Available at: https://pubrica.com/insights/how-physicians-can-write-clear-and-impactful-patient-education-materials/ (Accessed: 15 October 2026).
Pubrica Academy. “Writing Patient Education Materials that Change Adherence.” Pubrica. February 18, 2026. https://pubrica.com/insights/how-physicians-can-write-clear-and-impactful-patient-education-materials/
Pubrica Academy, ‘Writing patient education materials that change adherence’ (Pubrica, 18 February 2026) <https://pubrica.com/insights/how-physicians-can-write-clear-and-impactful-patient-education-materials/> accessed 15 October 2026.
Pubrica Academy. Writing patient education materials that change adherence. [Internet]. Pubrica; 2026 Feb 18 [cited 2026 Oct 15]. Available from: https://pubrica.com/insights/how-physicians-can-write-clear-and-impactful-patient-education-materials/
Pubrica Academy, “Writing patient education materials that change adherence,” Pubrica, Feb. 18, 2026. [Online]. Available: https://pubrica.com/insights/how-physicians-can-write-clear-and-impactful-patient-education-materials/
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title = {Writing patient education materials that change adherence},
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year = {2026},
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url = {https://pubrica.com/insights/how-physicians-can-write-clear-and-impactful-patient-education-materials/},
note = {Accessed: <span data-cite-acc="iso">2026-10-15</span>}
}This article is written to be learned from. Cite it if you are referring to what it says; if you are using the evidence behind it, cite the sources listed above instead.
Pubrica AcademyWritten and maintained by the subject matter experts of Pubrica who do this work. Articles are revised when the standard underneath them moves, and each one carries the date it was last checked.
How Pubrica helps
Patient education content covers writing and restructuring, with a readability and structure check against the standard that applies to your document. Where the material forms part of a regulated pack, regulatory writing prepares what goes into your own review process.