Differences in Reading Level and Commercial Information Content in Pharmacy-Provided Health Information Printouts



To determine whether the reading level of health information printouts and the inclusion of commercial information varied in a statistically significant manner in printouts obtained from a retail pharmacy.


A total of 31 different health information printouts were evaluated for reading level using the Simplified Measure of Gobbledygook (SMOG) readability analysis. Chi-square was used to determine differences in the presence or absence of four commercial content parameters: mention of a health organization, mention of a manufacturer, mention of a drug, or mention of a dose.


A single-sample t-test revealed a statistically significant difference in reading level among the health information printouts, t(30) = 47.91, p < 0.000, two-tailed. Chi-square analysis found no significant difference in whether a health organization, χ2(1, n = 31) = 1.58, p = 0.21, or a manufacturer, χ2 (1, n = 31) = 2.61, p = 0.11, were mentioned. There was a statistically significant difference in whether a drug, χ2(1, n = 31) = 9.32, p = 0.002, or a dose, χ2(1, n = 31) = 20.16, p = 0.000, was mentioned.


The fact that reading levels and the mention of a drug or dose was significantly different among the printouts suggests that these were not random events. It is thought that printouts, which have strong commercial overtones, are prepared in a manner to influence consumers to seek these products from their health care provider and not to strictly provide information on a particular health condition or disease state.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 189

This is the net price. Taxes to be calculated in checkout.


  1. 1.

    United States Department of Education. 1992 National Adult Literacy Survey: Overview. (Accessed March 11, 1999)

  2. 2.

    Davis TC, Crouch MA, Wills G, Miller S, Abdehou DM. The gap between patient reading comprehension and the readability of patient education materials. J Family Practice. 1990;31(5):533–538.

  3. 3.

    Davis TC, Mayeaux EJ, Fredrickson D, Bocchini JA, Jackson RH, Murphy PW. Reading ability of parents compared with reading level of pediatric patient education materials. Pediatrics. 1994;93(4):460–468.

  4. 4.

    Jackson RH, Davis TC, Bairnsfather LE, George RB, Crouch MA, Gault H. Patient reading ability: An overlooked problem in health care. Southern Med J. 1991;84(10):1172–1175.

  5. 5.

    Leichter SB, Nieman JA, Moore RW, Collins P, Rhodes A. Readability of self-care instructional pamphlets for diabetic patients. Diabetes Care. 1981;4(6):627–629.

  6. 6.

    McNeal B, Salisbury Z, Baumgardner P, Wheeler FC. Comprehension assessment of diabetes education program participants. Diabetes Care. 1984;7(3):232–235.

  7. 7.

    Meade CD, Byrd JC. Patient literacy and the readability of smoking education literature. Am J Public Health. 1989;79(2):204–206.

  8. 8.

    Morrow GR. How readable are subject consent forms? J Am Med Assoc. 1980;244(1):56–58.

  9. 9.

    Powers RD. Emergency department patient literacy and the readability of patient-directed Materials. Ann Emergency Med. 1988;17(2):124–126.

  10. 10.

    Ryan-Haddad A, Bramble JD, Lee B, Mucker A, Kellner V. OTC product labels and older patients. U.S. Pharmacist. January 2000:38–47.

  11. 11.

    Smith S. Readability testing health information. (Accessed February 17, 1999)

  12. 12.

    Marinac JS. Outpatient Cardiology. In Burke JM, Coonce SL, DeYoung GR, Hak LJ, Kuehl PG, Marinac JS, Mays-Holland TA, McMullin T, Oles KS, Smith CL. (Eds.) 2000 Update in Therapeutics. Kansas City, MO: American College of Clinical Pharmacy; 2000: 334.

Download references

Author information

Correspondence to Philip D. Rolland BS Pharmacy, MEd Psychology, RpH.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Rolland, P.D. Differences in Reading Level and Commercial Information Content in Pharmacy-Provided Health Information Printouts. Ther Innov Regul Sci 36, 187–192 (2002) doi:10.1177/009286150203600124

Download citation

Key Words

  • Commercial information
  • Health information
  • Literacy
  • Readability analysis