Reassessing the Readability of British Association of Dermatologists’ Patient Information Leaflets in 2025: Progress Toward Improved Health Literacy and Accessibility

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ID: 313931
2026
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Abstract
Abstract Background Patient Information Leaflets (PILs) are recommended to be written at or below a US Grade 6 reading level (UK Year 7; age 11-12) to ensure accessibility. They support patient understanding, self-management, and treatment adherence. Prior analyses from 2021 showed that most British Association of Dermatologists (BAD) PILs exceed this benchmark. This study provides an updated evaluation of their readability. Objectives To reassess the readability of BAD PILs in 2025 and compare findings with 2021 data. Methods 230 BAD PILs were analysed using Readability Studio (Oleander Software, USA). Standard readability metrics included Flesch–Kincaid (FK), Simple Measure of Gobbledygook (SMOG), Gunning Fog Index (GFI), Fry, FORCAST, and Flesch Reading Ease (FRE). Results were compared with 2021 values (GraphPad Prism V10.4.1 and Psychometrica) Results Mean US grade levels for 2025 vs 2021 were: FK 9.64 vs 9.8, SMOG 12 vs 12.1, GFI 11.6 vs 11.8, Fry 11.2 vs 11, FORCAST 10.7 vs 10.7, and FRE 52.8 vs 52.2. Readability corresponded to UK Year 10-13. Only 1.3% of PILs (3/230) met the US Grade ≤6 benchmark. Effect sizes were negligible (Cohen’s d, +0.115 to –0.164), with no meaningful improvement since 2021. Additionally, 40.4% of PILs were overdue for review. Conclusions BAD PIL readability has not improved over four years and remains above recommended levels. Overdue reviews may contribute to this persistence. Improvement will require systematic redesign using plain-language principles alongside more consistent review processes.
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Authors Akua O Asare, Sian El-Louise Obeng, Ryan Syed, Felmy Ajayi
Journal clinical and experimental dermatology
Year 2026
DOI
10.1093/ced/llag200
URL
https://doi.org/10.1093/ced/llag200
Keywords Keywords not found

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