Health literacy and knowledge of chronic disease

Gazmararian, Julie A.; Williams, Mark; Peel, Jennifer L.; Baker, David W.

doi:10.1016/s0738-3991(02)00239-2

Cited by 766 publications

(616 citation statements)

References 29 publications

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“…15 Misuse was defined as <75% of steps correct for each device (<9/12 steps for MDI; <8/10 steps for Diskus®). 15 Because inadequate health literacy is associated with poor inhaler technique, 24,25 participants' health literacy was measured using the Short Test of Functional Health Literacy in Adults (STOFHLA), 26,27 a 36-item written comprehension test (scores: range 0-36); less-than-adequate: <23/36; adequate: ≥23/36. 26 Participants with screened visual acuity better than 20/50 in ≥1 eye were eligible to complete the STOFHLA.…”

Section: Study Proceduresmentioning

confidence: 99%

Teaching the Use of Respiratory Inhalers to Hospitalized Patients with Asthma or COPD: a Randomized Trial

et al. 2012

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BACKGROUND:Hospitalized patients frequently misuse their respiratory inhalers, yet it is unclear what the most effective hospital-based educational intervention is for this population. OBJECTIVE: To compare two strategies for teaching inhaler use to hospitalized patients with asthma or chronic obstructive pulmonary disease (COPD). DESIGN: A Phase-II randomized controlled clinical trial enrolled hospitalized adults with physician diagnosed asthma or COPD. PARTICIPANTS: Hospitalized adults (age 18 years or older) with asthma or COPD. INTERVENTIONS: Participants were randomized to brief intervention [BI]: single-set of verbal and written step-by-step instructions, or, teach-to-goal [TTG]: BI plus repeated demonstrations of inhaler use and participant comprehension assessments (teach-back). MAIN MEASURES: The primary outcome was metereddose inhaler (MDI) misuse post-intervention (<75% steps correct). Secondary outcomes included Diskus® misuse, self-reported inhaler technique confidence and prevalence of 30-day health-related events. KEY RESULTS: Of 80 eligible participants, fifty (63%) were enrolled (BI n=26, TTG n=24). While the majority of participants reported being confident with their inhaler technique (MDI 70%, Diskus® 94%), most misused their inhalers pre-intervention (MDI 62%, Diskus® 78%). Post-intervention MDI misuse was significantly lower after TTG vs. BI (12.5 vs. 46%, p= 0.01). The results for Diskus® were similar and approached significance (25 vs. 80%, p=0.05). Participants with 30-day acute health-related events were less common in the group receiving TTG vs. BI (1 vs. 8, p=0.02).CONCLUSIONS: TTG appears to be more effective compared with BI. Patients over-estimate their inhaler technique, emphasizing the need for hospital-based interventions to correct inhaler misuse. Although TTG was associated with fewer post-hospitalization healthrelated events, larger, multi-centered studies are needed to evaluate the durability and clinical outcomes associated with this hospital-based education.

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Section: Study Proceduresmentioning

confidence: 99%

Teaching the Use of Respiratory Inhalers to Hospitalized Patients with Asthma or COPD: a Randomized Trial

et al. 2012

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“…As we might expect, low health literacy is related to knowledge about disease. Gazmararian and colleagues [81] report that of 653 Medicare recipients, 266 of whom had diabetes, 36% had marginal or inadequate health literacy. Health literacy in this population was independently related to knowledge about diabetes.…”

Section: Health Literacy and Patient Adherencementioning

confidence: 99%

The Role of Culture in Health Literacy and Chronic Disease Screening and Management

Shaw

Huebner

Armin

et al. 2008

J Immigrant Minority Health

195

132

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“…(1) Patients with inadequate health literacy are more likely to have difficulty understanding written health materials, processing oral communication, and navigating health care environments than those with adequate health literacy. Inadequate health literacy is common, found in one fourth to one third of previously studied populations, and has been linked to poorer health-related knowledge, more health care utilization, and worse outcomes (2)(3)(4)(5)(6)(7).…”

mentioning

confidence: 99%

Health Literacy and Access to Kidney Transplantation

Grubbs

Gregorich

Pérez‐Stable

et al. 2009

Clinical Journal of the American Society of Nephrology

165

149

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Background and objectives: Few studies have examined health literacy in patients with end stage kidney disease. We hypothesized that inadequate health literacy in a hemodialysis population is common and is associated with poorer access to kidney transplant wait-lists.Design, setting, participants, & measurements: We enrolled 62 Black and White maintenance hemodialysis patients aged 18 to 75. We measured health literacy using the short form Test of Functional Health Literacy in Adults. Our primary outcomes were (1) time from dialysis start date to referral date for kidney transplant evaluation and (2) time from referral date to date placed on kidney transplant wait-list. We used Cox proportional hazard models to examine the association between health literacy (adequate versus inadequate) and our outcomes after controlling for demographics and co-morbid conditions.Results Conclusions: Inadequate health literacy is common in our hemodialysis patient population and is associated with a lower hazard of referral for transplant evaluation. Strategies to reduce the impact of health literacy on the kidney transplant process should be explored.

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Health literacy and knowledge of chronic disease

Cited by 766 publications

References 29 publications

Teaching the Use of Respiratory Inhalers to Hospitalized Patients with Asthma or COPD: a Randomized Trial

Teaching the Use of Respiratory Inhalers to Hospitalized Patients with Asthma or COPD: a Randomized Trial

The Role of Culture in Health Literacy and Chronic Disease Screening and Management

Health Literacy and Access to Kidney Transplantation

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