Talking Labels

1
Talking Labels Improving Consultations in
General Practice for non-English speaking
patients Margot Jackson John Skinner Sheffield
West Primary Care Trust
Background A significant percentage of the
information given in medical consultations is
forgotten. Research1, 2 has shown that 40 80
of medical information provided by hospital
practitioners is forgotten immediately and almost
half of the information that is remembered will
be incorrect3. In most cases medical advice is
spoken but it seems that written information is
better remembered and leads to better treatment
adherence4. Written information however is not
necessarily appropriate for people with low
literacy or to non-English speakers. Compliance
with the information given in a consultation is
vital to recovery, and is made more difficult if
information is forgotten. For people from BME
groups who are not fluent in English the problems
with understanding, asking questions, and
remembering advice given is likely to be more
acute. Tape recordings of consultations have
successfully been carried out in hospital
settings and show that both patients and
physicians find them a valuable tool improving
patient-physician communication5,6.   This study
piloted the application of a new technology to
information giving in primary care through the
use of digital recording devices. Talking
Labels Talking Labels are small digital
recording devices, slightly larger than a credit
card, (80mm x 57mm x 10mm) which will allow up to
one minute of audio information to be recorded.
A small microphone is built into the back of the
device and information can be played back by
pressing a large button on the front of the
device. The message on the digital recording
device can be changed at any time by recording
over any existing audio information. The
microphone is activated by pressing a sunken
switch with the point of a pen or pencil. It is
therefore easy for someone who knows how, to
record information but not easy for someone to
accidentally erase or change the message. They
are small enough to be carried around in a pocket
or could be clipped onto a box of prescribed
medicine, and have been produced at a low unit
cost.   These devices have only recently become
available, but offer the potential of
personalising information for patients to take
away to listen to at home so they can be reminded
of the advice they have been given. For people
from black and ethnic minority groups, if an
interpreter is present during a consultation they
enable information to be recorded onto the
Talking Label in their own language.
Aim The project aimed to investigate patients
perceived benefits of receiving personalised
health information in an audio format on a
digital recording device, and to establish
whether the equipment used was suitable for
purpose.   Method All Somali patients attending
general practice who needed an interpreter were
invited to take part in the study and receive a
personalised digital recording of information
about their health to take home with them at the
end of their consultation with a health
professional. Participants were followed up one
week later by trained interpreters who carried
out a telephone administered questionnaire on
acceptability and usage in their own language.
In total 68 recording devices were given out and
58 people were interviewed. Results Of the
patients who took part 81 were women, mainly
aged 55. Some people were at first reluctant to
accept a digital recording device as they did not
want to be telephoned at home. However, after
the project had been going a few weeks people
began to come to the surgery and ask for a
recording device. 51 of the 58 interviewees had
listened to the information on the DRD, around
half reporting that they had listened many times.
 The digital recording devices were robust and
easy to use. Only one person could not get the
device to work and this could have been a battery
problem.

• Patients Perceptions
• Patients perceived the audio recordings helped
  them in different ways. Many patients mentioned
  that they used to forget how to take their
  prescribed medication, but the DRD helped them to
  take it correctly.
•  
• I listen whenever I want to take my medication
  to make sure that
  I am taking the right amount or in the right
  time.
•  
• Those unable to read English found the devices
  especially useful in enabling them to remember
  advice given. Many patients said that it helped
  them to remember appointments that they would
  otherwise have forgotten.
•  
• I am elderly woman, I always forget appointment,
  but now the device helps me.
•  
• Older people and those with memory problems felt
  that the digital recording device was useful as
  they were aware that they forgot many things
•  
• I have got hard time remembering things so to
  have it recorded helps me.
•  
• I use to forget the way I am taking the
  medication, but since I receive the device I find
  very useful remembering.
•  
• The digital recording devices in this study were
  used mainly to record information about
  appointments and medication. People who were
  interviewed felt that they could be used to
  record anything that was relevant to their
  health, e.g.
•  
• Any information that will help me be medically
  wise.
•