Innovative ways to facilitate the understanding and communication of traditional Chinese medical terms and theories in a Patient Decision Aid

Article type
Authors
Mu W1, Fu S2, He Y3, Li Y1, Wang B4, Huang Y1
1Department of Clinical Pharmacology, Second Affiliated Hospital of Tianjin Unversity of Traditional Chinese Medicine
2College of Chinese Medicine, Tianjin University of Traditional Chinese Medicine
3Pharmacy Department, Second Affiliated Hospital of Tianjin Unversity of Traditional Chinese Medicine
4Second Affiliated Hospital of Tianjin Unversity of Traditional Chinese Medicine
Abstract
Background
In English-speaking countries, there are guidance documents on writing in plain language. For example, the Cochrane methods group released the Standards for the Reporting of Plain Language Summaries in 2013, setting out rules and elaborating on the mandatory attributes of the language used in a summary of a Cochrane systematic review. As far as we know, there is no such guidance for writing medical texts in plain Mandarin, especially concerning traditional Chinese medicine (TCM).

Objectives
In developing a patient decision aid (PtDA), our research team looked at methods to best present information about TCM theories and therapies.

Methods
As there is no rule to follow, we organized a panel meeting for brainstorming after the PtDA was drafted. The PtDA developers, a university lecturer in TCM classics, and a pharmacist-in-chief of Chinese materia medica joined the discussion. Innovative ways were proposed and discussed for feasibility until consensus was reached.

Results
In our PtDA designed for stable angina patients, we provided information about four medication therapies, including two Chinese patent medicines. To better communicate these herbal components and their health effects to the patients, we broke down the whole formula into clusters of couplet medicinals or single herbs and presented them in order of their functionality and quantity. The health effects of a group of couplet medicinals or a single herb were first explained in the classical TCM language; for example, “Huangqi, a herbal medicine, boosts qi and frees the vessels”. Their pharmacological effects corresponding to or supporting the health effects were then provided in the modern biomedical language in a different colour; for example, “Huangqi protects heart muscle and relaxes blood vessels”. The explanations in classical TCM terms were based on a TCM textbook. The corresponding or supporting pharmacological effects were based on findings of pharmacological research.

Conclusions
This method creates a visually structured text to make this part of the PtDA more comprehensible. This helps healthcare consumers get instant access to the information they need in order to distinguish between different options. The PtDA can be found at https://decisionaid.ohri.ca/AZsumm.php?ID=1930.

Patient or healthcare consumer involvement
Two patient representatives were invited to review the finalized PtDA and give comments on readability.