The authors evaluated PEMs written in English from AUGS, AUA, SUFU, ICS, IUGA, ACOG, and NAFC. Four different validated measures were used to evaluate the readability of each PEM. Each PEM item was assessed separately, and a mean readability level was assigned based on grade level. An average readability score was then assessed by topic, including POP, OAB, and SUI.
The PEMs assessed included 7 for POP, 8 for OAB, and 7 for SUI. The PEMs for POP showed the highest mean grade level, at 12.31 (SD 1.89), out of all that were evaluated. OAB PEMs had a lower mean grade level at 9.37 (SD 2.99), and SUI PEMs had a grade level 11.53 (SD 2.54). The only PEMs written at or below the 7th grade level, as recommended by the AMA, were those from SUFU regarding OAB. These included SUFUs Roadmap for Overactive Bladder Clinical Care Pathway and Changes You Can Make to Improve Bladder Problems. None of the PEMs were written at or below the 5th grade level as recommended by the Joint Commission.
Overall, this study highlights an important issue in patient education and care. PEMs on POP, in particular, are written above the 10th grade level. Patients often have difficulty remembering and recalling information given to them by physicians. In addition, with the increasing pressure to see more patients, physicians are limited in the amount of face to face education that can be provided, and many rely on handouts such as these to supplement these discussions. Without appropriately-written PEMs, patients may not be able to understand their conditions, and this could lead to confusion about, or disappointment in, their care. Future development of PEMs for POP, OAB, and SUI by national specialty societies should focus on improved readability for patients.
![AUA2019_PEMs_on_POPv2.jpg](/images/AUA2019_PEMs_on_POPv2.jpg)
Presented by: Chris Du, Stony Brook University, Stony Brook, New York, United States
Written by: Dena Moskowitz, MD, Assistant Professor of Clinical Urology, University of California Irvine; @demoskowitz at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois