Delaware County Medical Society Summer 2017 - 5

Evidence for Teach-Back
A systematic review of 12 studies suggests that chronic illness outcomes in adults may be improved statistically and/or clinically with the
use of teach-back. Specifically, increased adherence to diet, exercise,
and foot care among patients with diabetes as well as improved adherence to daily weights among patients with heart failure was noted in two
studies. Five studies found a reduction in readmission rates and hospitalization among those with heart failure after teach-back, but these
data were not always statistically significant. Overall, the review showed
improved outcomes in disease specific knowledge, adherence, and selfefficacy and use of an inhaler among COPD patients. There was also a
positive trend in improved self-management and reduced readmission
rates, but this was not always consistent or statistically significant. One
study conducted during pediatric primary care encounters found that
teach-back was associated with more patient-centered communication
and parent engagement. Finally, teach-back is one of 11 top safety practices based on strength of evidence according to AHRQ.

language for most of our patients.
How we teach patients and their
families can have a significant impact
on quality care and patient safety-
as in the case of the grandfather
and his granddaughter. We likely
don't have to ponder for very long
to remember stories from our own
practices that were near misses, some
perhaps with tragic endings, all stemming from miscommunication.

One promising, evidence based
method for providing patient education is the Teach-Back Method,
also called "closing the loop" or
"show me." This method, endorsed
by AHRQ and the National Quality
Forum, helps clinicians confirm the
message patients hear is the intended
message and that the clinician and
patient have come to a shared meaning regarding the subject at hand.
Research shows that patients remember and understand less than half
of what clinicians explain to them.
Patients may try to hide their lack of
understanding of health information
due to fear of being embarrassed,
misunderstood or disrespected.
Teach-back helps to support that

www.delcomedsoc.org

health education messages have been delivered and received as expected, in a fashion
that is both understandable and usable for
patients/families-to evaluate whether true
learning of required medical information has
occurred. This brief article expands a) on
the evidence for teach-back, b) the process
of teach-back, and c) how to use teach-back
appropriately so as to protect patient dignity
by keeping the onus for clarity on the clinician rather than shaming the patient for not
understanding. Pros and cons of teach-back
are also outlined.

DELAWARE COUNTY MEDICINE & HEALTH

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Table of Contents for the Digital Edition of Delaware County Medical Society Summer 2017

Delaware County Medical Society Summer 2017 - 1
Delaware County Medical Society Summer 2017 - 2
Delaware County Medical Society Summer 2017 - 3
Delaware County Medical Society Summer 2017 - 4
Delaware County Medical Society Summer 2017 - 5
Delaware County Medical Society Summer 2017 - 6
Delaware County Medical Society Summer 2017 - 7
Delaware County Medical Society Summer 2017 - 8
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Delaware County Medical Society Summer 2017 - 17
Delaware County Medical Society Summer 2017 - 18
Delaware County Medical Society Summer 2017 - 19
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Delaware County Medical Society Summer 2017 - 24
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