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We’ve done many columns on the dangers of abbreviations in healthcare. These have predominantly been involved in medication errors, but we’ve also seen them contribute to wrong-site surgeries. But now there is a new circumstance where abbreviations can be problematic – when patients are accessing their electronic medical records or when we communicate with them by email.
Grossman Liu et al. (Grossman Liu 2022) looked at patient comprehension of some abbreviations commonly found the EHR. They compared the rates of patient comprehension of the terms when the abbreviation was used compared to notes where the term was written out fully. Whereas only 20% understood the term “HF”, 100% understood “heart failure”. Only 23% understood “HTN”, but 97% understood “hypertension". Only 43% understood “hx”, whereas all understood “history”. But some terms, such as “MI” and “myocardial infarction” were both poorly understood.
In an interview with Medscape Medical News (McCormack 2022), Grossman Liu pointed out that some abbreviations can stand for more than one thing. For example, the abbreviation “PA” has as many as 128 possible meanings!
We use medical abbreviations and acronyms extensively in our documentation. We need to be concerned that we don’t use terms that will lead to confusion on the part of our patients. A little extra work when we input data and records can probably go a long way to avoid problems that can arise from terms confusing to our patients.
The authors conclude their findings suggest that post hoc or automated expansion of medical abbreviations and acronyms can improve patient understanding of their health information. Note that their study only included only English-speaking adult patients with diagnosed heart failure. It is not clear if the same results would apply to other patient populations or those with other medical conditions.
Bottom line: we all need to be cognizant of the fact that our medical jargon may not be well understood by our patients, whether verbally or in electronic formats.
Some of our previous columns on the impact of abbreviations in healthcare:
March 12, 2007 “10x Overdoses”
June 12, 2007 “Medication-Related Issues in Ambulatory Surgery”
September 2007 “The Impact of Abbreviations on Patient Safety”
July 14, 2009 “Is Your “Do Not Use” Abbreviations List Adequate?”
April 2015 “Pediatric Dosing Unit Recommendations”
December 22, 2015 “The Alberta Abbreviation Safety Toolkit”
May 14, 2019 “Wrong-Site Surgery and Difficult-to-Mark Sites”
Grossman Liu L, Russell D, Reading Turchioe M, Myers AC, Vawdrey DK, Masterson Creber RM. Effect of Expansion of Abbreviations and Acronyms on Patient Comprehension of Their Health Records: A Randomized Clinical Trial. JAMA Netw Open 2022; 5(5): e2212320
McCormack J. Spell It Out: Writing Out Common Medical Terms Boosts Patient Understanding, Says Study. Medscape Medical News 2022; May 16, 2022
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