Health literacy and adherence to treatment of patients with heart failure (original) (raw)

Factors associated with exacerbation of heart failure include treatment adherence and health literacy skills

Clinical pharmacology and therapeutics, 2009

We determined the factors associated with exacerbation of heart failure, using a cohort (n = 192) nested within a randomized trial at a university-affiliated ambulatory practice. Factors associated with emergency or hospital care included left ventricular ejection fraction, hematocrit and serum sodium levels, refill adherence, and the ability to read a prescription label. Refill adherence of <40% was associated with a threefold higher incidence of hospitalization for heart failure than a refill adherence of >or=80% (P = 0.002). In multivariable analysis, prescription label reading skills were associated with a lower incidence of heart failure-specific emergency care (incidence rate ratio, 0.76; 95% confidence interval (CI), 0.19-0.69), and participants with adequate health literacy had a lower risk of hospitalization for heart failure (incidence rate ratio, 0.34; 95% CI, 0.15-0.76). We conclude that inadequate treatment adherence and health literacy skills are key factors in t...

Evaluating the Impact of Health Literacy on Medication Adherence and Outcomes in Patients with Heart Failure

2018

O ne of the core concepts of the Patient Centered Medical Home (PCMH) is to facilitate a partnership between patients and practitioners to help ensure patients have the knowledge and feel empowered to actively participate in setting goals for their own health care.1 An integral component to success of this partnership is understanding the barriers that prevent a patient from reaching specific treatment goals. One such barrier may include poor health literacy, which is defined by the Institute of Medicine as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”2 Health literacy is not regularly assessed by health care practitioners, even though low health literacy, including its effect on medication adherence, has a potential negative effect on health outcomes. For example, patients who have poorer understanding about disease processes and medications used to treat them...

How can health literacy influence outcomes in heart failure patients? Mechanisms and interventions

Current heart failure reports, 2013

Health literacy is discussed in papers from 25 countries where findings suggest that approximately a third up to one half of the people in developed countries have low health literacy. Specifically, health literacy is the mechanism by which individuals obtain and use health information to make health decisions about individual treatments in the home, access care in the community, promote provider-patient interactions, structure self-care, and navigate health care programs both locally and nationally. Further, health literacy is a key determinant of health and a critical dimension for assessing individuals' needs, and, importantly, their capacity for self-care. Poorer health knowledge/status, more medication errors, costs, and higher rates of morbidity, readmissions, emergency room visits, and mortality among patients with health illiteracy have been demonstrated. Individuals at high risk for low health literacy include the elderly, disabled, Blacks, those with a poverty-level in...

Health literacy and mortality: a cohort study of patients hospitalized for acute heart failure

Journal of the American Heart Association, 2015

More than 30% of patients hospitalized for heart failure are rehospitalized or die within 90 days of discharge. Lower health literacy is associated with mortality among outpatients with chronic heart failure; little is known about this relationship after hospitalization for acute heart failure. Patients hospitalized for acute heart failure and discharged home between November 2010 and June 2013 were followed through December 31, 2013. Nurses administered the Brief Health Literacy Screen at admission; low health literacy was defined as Brief Health Literacy Screen ≤9. The primary outcome was all-cause mortality. Secondary outcomes were time to first rehospitalization and, separately, time to first emergency department visit within 90 days of discharge. Cox proportional hazards models determined their relationships with health literacy, adjusting for age, gender, race, insurance, education, comorbidity, and hospital length of stay. For the 1379 patients, average age was 63.1 years, 56...

Health Literacy and the Patient With Heart Failure—Implications for Patient Care and Research: A Consensus Statement of the Heart Failure Society of America

Journal of Cardiac Failure, 2010

Background: Low health literacy compromises patient safety, quality health care, and desired health outcomes. Specifically, low health literacy is associated with decreased knowledge of one's medical condition, poor medication recall, nonadherence to treatment plans, poor self-care behaviors, compromised physical and mental health, greater risk of hospitalization, and increased mortality. Methods: The health literacy literature was reviewed for: definitions, scope, risk factors, assessment, impact on health outcomes (cardiovascular disease and heart failure), and interventions. Implications for future research and for clinical practice to address health literacy in heart failure patients were summarized. Results: General health literacy principles should be applied to patients with heart failure, similar to others with chronic conditions. Clinicians treating patients with heart failure should address health literacy using five steps: recognize the consequences of low health literacy, screen patients at risk, document literacy levels and learning preferences, and integrate effective strategies to enhance patients' understanding into practice. Conclusion: Although the literature specifically addressing low health literacy in patients with heart failure is limited, it is consistent with the larger body of health literacy evidence. Timely recognition of low health literacy combined with tailored interventions should be integrated into clinical practice. (J Cardiac Fail 2010;16:9e16)

Exploring the Importance of Health Literacy for the Quality of Life in Patients with Heart Failure

International Journal of Environmental Research and Public Health, 2018

As with all other chronic noncommunicable diseases, adequate health literacy plays a key role in making the right decisions in the treatment of heart failure. Patients with heart failure and a lower health literacy have a reduced quality of life. A cross-sectional study among 200 patients with heart failure was conducted at a state university hospital in Belgrade, Serbia. The European Health Literacy Questionnaire, HLS-EU-Q47, was used to assess health literacy. Quality of life was measured with the generic SF-36 and the Minnesota Living with Heart Failure Questionnaire. Descriptive and analytical statistical analysis was applied. More than half of the respondents (64%) had limited health literacy. The lowest mean health literacy index (28.01 ± 9.34) was within the disease prevention dimension, where the largest number of respondents showed limited health literacy (70%). Our patients had a poorer quality of life in the physical dimension, and the best scores were identified in the e...

Effect of health literacy on drug adherence in patients with heart failure

Pharmacotherapy, 2012

To assess the effect of health literacy on drug adherence in the context of a pharmacist-based intervention for patients with heart failure. Post hoc analysis of a randomized controlled trial. Inner-city ambulatory care practice affiliated with an academic medical center. The original trial enrolled 314 patients with heart failure who were aged 50 years or older and were taking at least one cardiovascular drug for heart failure; 122 patients received the pharmacist intervention (patient education, therapeutic monitoring, and communication with primary care providers), and 192 patients received usual care (regular follow-up with primary care providers). We analyzed the results of 281 patients who had available health literacy and adherence data. Drug adherence was assessed over 9 months using electronic prescription container monitors on cardiovascular drugs. Health literacy was assessed using the Short Test of Functional Health Literacy in Adults (scores range from 0-36, with an ade...

Correlates of Health Literacy in Patients With Chronic Heart Failure

2006

in health literacy. Implications: The association of cognitive abilities and literacy has important implica- tions for health literacy models and for interventions to reduce the impact of low health literacy on health outcomes.Forexample,medicationinstructionsshould be designed to reduce comprehension demands on general cognitive abilities as well as literacy skills.

Health Literacy and Heart Failure

Journal of Cardiovascular Nursing, 2016

Background-Low health literacy affects millions of Americans, putting those who are affected at a disadvantage and at risk for poorer health outcomes. Low health literacy can act as a barrier to effective disease self-management; this is especially true for chronic diseases such as heart failure (HF) that require complicated self-care regimens. Purpose-This systematic review examined quantitative research literature published between 1999 and 2014 to explore the role of health literacy among HF patients. The specific aims of the systematic review are to (1) describe the prevalence of low health literacy among HF patients, (2) explore the predictors of low health literacy among HF patients, and (3) discuss the relationship between health literacy and HF self-care and common HF outcomes. Methods-A systematic search of the following databases was conducted, PubMed, CINAHL Plus, Embase, PsycINFO, and Scopus, using relevant keywords and clear inclusion and exclusion criteria. Conclusions-An average of 39% of HF patients have low health literacy. Age, race/ethnicity, years of education, and cognitive function are predictors of health literacy. In addition, adequate health literacy is consistently correlated with higher HF knowledge and higher salt knowledge. Clinical Implications-Considering the prevalence of low health literacy among in the HF population, nurses and healthcare professionals need to recognize the consequences of low health literacy and adopt strategies that could minimize its detrimental effect on the patient's health outcomes.

The Relationship Between Health Literacy Level and Quality of Life in Heart Failure Patients

2021

Background and Objective: Heart failure is one of the most common cardiovascular disorders and also it is one of the main problems of general health in the current society. Considering the role of health literacy in improving the quality of life of patients, the present study was conducted to determine the health literacy status of patients with heart failure hospitalized in Shahid Mohammadi Hospital in Bandar Abbas and its relationship with quality of life in these patients. Materials and Methods: This cross-sectional study was performed on 200 patients with heart failure hospitalized in Shahid Mohammadi Hospital in Bandar Abbas in 2019. Sampling was random sampling in even days of week. Data was collected by two questionnaires including standard questionnaire of health literacy and the Minnesota Quality of Life Questionnaire (MLHF). The reliability of each scale was tested by Cronbach alpha. Data were analyzed by descriptive statistics and Pearson correlation test using SPSS 21 so...