The Role of Health Literacy and Written Medicine Information in Nonsteroidal Antiinflammatory Drug Risk Awareness

Miller, Michael J.; Schmitt, Michael R.; Allison, Jeroan J.; Cobaugh, Daniel J.; Ray, Midge N.

doi:10.1345/aph.1m479

Cited by 23 publications

(15 citation statements)

References 35 publications

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“…21,22 The decreased likelihood of PPI prescription at discharge in Medicaid and Medicare insured patients on combination aspirin and anticoagulation supports previous studies from the United States in which higher income correlates with increased rates of PPI prescription. Possible explanations include increased patient awareness of PPIs, decreased need for prior authorization, and ability to pay higher copayments among higher income, privately insured patients.…”

Section: Discussionsupporting

confidence: 73%

Low adherence to national guidelines for proton-pump inhibitor prescription in patients receiving combination aspirin and anticoagulation

Sharma

Roy

Ramos

et al. 2017

Therap Adv Gastroenterol

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Background:Aspirin, when used with concurrent anticoagulation, increases the risk of gastrointestinal bleeding (GIB). Therefore, multisociety guidelines recommend prophylactic proton-pump inhibitors (PPIs) for patients receiving aspirin and anticoagulation. We aimed to determine rates and predictors of adherence to these recommendations.Methods:All adult inpatients discharged from the hospital on aspirin and anticoagulation from July 2009 to June 2014 were retrospectively evaluated for PPI prescription on discharge instructions. We used univariate and multivariate logistic regression to test for predictors of PPI prescription.Results:A total of 2422 patients were discharged on aspirin and anticoagulation; the mean age was 68 years and 53.2% were male; 42.2% were prescribed a PPI at discharge. On univariate analysis, factors associated with discharge PPI prescription included increased age (47.1% versus 37.9%), white race (47.3% versus 37.1–40.2%), higher aspirin dose (55.1% versus 39.4%), being married (46.2% versus 39.4%) and preadmission PPI use (96.6% versus 23.4%). On multivariate analysis, significant predictors of discharge PPI prescription were age 60–69 years [odds ratio (OR) 1.61] and 70–79 years (OR 1.48), and preadmission PPI use (OR 120.03). Lower odds of discharge PPI prescription included Medicaid (OR 0.55) or Medicare (OR 0.71) insurance, Spanish language (OR 0.63), and lower dose aspirin (81 mg) (OR 0.40).Conclusions:A total of 42.2% of patients discharged on aspirin and anticoagulation were prescribed PPIs. Older age and preadmission PPI use were predictive of PPI prescription, while Medicaid/Medicare insurance, Spanish language, and lower dose aspirin decreased the likelihood of discharge PPI prescription. This creates an opportunity to improve primary GIB prevention through quality improvement interventions.

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Section: Discussionsupporting

confidence: 73%

Low adherence to national guidelines for proton-pump inhibitor prescription in patients receiving combination aspirin and anticoagulation

Sharma

Roy

Ramos

et al. 2017

Therap Adv Gastroenterol

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“…25,[33][34][35] Sociodemographic covariates included race (i.e., African American or white), age (i.e., <65 or ≥65 y), and insurance status (i.e., uninsured/Medicaid or any other insurance coverage).…”

Section: Measurementsmentioning

confidence: 99%

Screening Questions for Nonsteroidal Anti-inflammatory Drug Risk Knowledge

Bogert¹,

Miller²,

Cobaugh³

et al. 2017

J Patient Saf

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OBJECTIVE: The aim of this study was to evaluate screening questions for estimating nonsteroidal anti-inflammatory drug (NSAID) risk knowledge. METHODS: Cross-sectional data from a telephone interview of NSAID users 50 years or older from 39 physician practices in Alabama were used. Patient-reported awareness of prescription NSAID risk and health literacy were the independent variables, and a cumulative index score of objectively tested knowledge of 4 prominent NSAID risks was the dependent variable. General linearized latent and mixed model ordered logistic regression was used to estimate associations among the independent variables, covariates, and objectively tested NSAID risk knowledge. Population-averaged probabilities for levels of objectively tested NSAID risk knowledge were subsequently estimated. RESULTS: Subjective awareness of any prescription NSAID risk (adjusted odds ratio [AOR], 2.40; 95% confidence interval [CI], 1.55-3.74), adequate health literacy (AOR, 1.71; 95% CI, 1.04-2.83), and physician counseling about 1 or more NSAID risks (AOR, 1.69; 95% CI, 1.09-2.61) were significantly and positively associated with NSAID risk knowledge. The probability of correctly answering at least 1 of the 4 NSAID risk knowledge questions was 70% in the absence of any subjective risk awareness and in less than adequate health literacy. Whereas the probability of correctly answering at least 1 of the 4 NSAID risk knowledge questions increased to 86% in the presence of subjective awareness of any prescription NSAID risk and adequate health literacy. CONCLUSIONS: Screening questions for subjective NSAID risk awareness and health literacy are predictive of objectively tested NSAID knowledge and can be used to triage patients as well as subsequently initiate and direct a conversation about NSAID risk

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“…Distribution of patient targeted print education materials at pharmacies was not related to patient awareness of risk of nonsteroidal antiinflammatory drugs suggesting that more effective strategies to deliver medication information is needed (Miller et al, 2010). Oncology patients are expected to follow complex treatment regimens delivered by multiple providers over time; information is often delivered to patients and families at highly stressful times.…”

Section: Introductionmentioning

confidence: 99%

Medication Health Literacy Measure: Development and Psychometric Properties

Stilley¹,

Terhorst²,

Flynn³

et al. 2014

J Nurs Meas

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Background & Purpose Low levels of health literacy are prevalent world-wide. This report details development and psychometric properties of a health literacy measure for oral medications based on design of the Newest Vital Signs. Methods The measure was completed during the baseline interview. A Principal Components Analysis evaluated dimensionality of the measure. Cronbach's Alpha assessed subscale internal consistencies. Results Internal consistencies and reliability for the subscales were acceptable for a new instrument (α = .661), (α =.686), (α =.400). A three-factor structure explained 65.34% of the total variance. Divergent validity with the REALM was established. Conclusions Our data indicates that the medication health literacy tool is multi-dimensional, valid, and reliable. This information is important in light of emerging evidence of the impact of health literacy on medication adherence and health.

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The Role of Health Literacy and Written Medicine Information in Nonsteroidal Antiinflammatory Drug Risk Awareness

Cited by 23 publications

References 35 publications

Low adherence to national guidelines for proton-pump inhibitor prescription in patients receiving combination aspirin and anticoagulation

Low adherence to national guidelines for proton-pump inhibitor prescription in patients receiving combination aspirin and anticoagulation

Screening Questions for Nonsteroidal Anti-inflammatory Drug Risk Knowledge

Medication Health Literacy Measure: Development and Psychometric Properties

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