Update on Health Literacy and Diabetes

Bailey, Stacy Cooper; Brega, Angela G.; Crutchfield, Trisha M.; Elasy, Tom A.; Herr, Haley; Kaphingst, Kimberly A.; Karter, Andrew J.; Moreland-Russell, Sarah; Osborn, Chandra Y.; Pignone, Michael; Rothman, Russell L.; Schillinger, Dean

doi:10.1177/0145721714540220

Cited by 254 publications

(292 citation statements)

References 78 publications

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“…Our research study is consistent with other studies that demonstrate that pharmaceutical care intervention can improve disease-related knowledge, clinical markers, and medication adherence in patients with hypertension and/or diabetes [15][16][17]. Future research with a larger sample size and a longer duration of time may determine if the effect of pharmacist management on disease-related knowledge, haemoglobin A1C, blood pressure and medication adherence is sustainable after study completion.…”

Section: Discussionsupporting

confidence: 89%

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Impact of Clinical Pharmacist Intervention on Medication Adherence and Disease related Knowledge among Patients with Low Health Literacy in Puerto Rico

Santiago¹,

Melin²

2015

J Pharma Care Health Sys

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Introduction: Patients living in central rural towns in Puerto Rico comprise one of the most critical at-risk populations of limited health literacy due to the higher incidence of poverty and lower educational levels within this sector. The objective of this study was to assess the effect of clinical pharmacist intervention on medication adherence and disease knowledge among patients with low health literacy from the municipalities of Adjuntas and Lares in Puerto Rico. Methods:This study used a prospective analysis of patients referred for a pharmacist educational intervention in two rural outpatient clinics of Puerto Rico. Thirteen patients with inadequate glycemic control (A1C ≥ 9%), uncontrolled hypertension (≥ 150/90) or medication non-adherence (PDC < 0.80) were referred to the study by a primary care physician. Initial health literacy was measured by the Spanish Short Test of Functional Health Literacy in Adults (S-TOFHLA). The primary outcome of the study was average change of medication adherence assessed by calculating the proportion days covered (PDC) at baseline and at the end of the study period. The secondary outcome of the study was average change in patient's disease-related knowledge using the Diabetes, Hypertension and Hyperlipidemia (DHL) knowledge instrument measured at baseline and at the end of the study period. The average change on hemoglobin A1C and blood pressure was also calculated between baseline and post-intervention evaluation. Results:The study showed a significant improvement in disease-related knowledge and modest improvements in disease clinical markers and medication adherence. Adherence improved from an average PDC of 0.59 to a PDC of 0.64. Disease related knowledge improved from an average 58% to an 83% in questionnaire scores. Conclusion:Due to small patient recruitment and the lack of statistically significant data in this study, further research with a larger patient population is required to accurately identify the potential benefits of these interventions.

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Section: Discussionsupporting

confidence: 89%

“…There are 36 items that are administered in 7 minutes. The scoring categorizes respondents into inadequate (0-16), marginal (17)(18)(19)(20)(21)(22) or adequate levels (23-36) of health literacy [12].…”

Section: Methodsmentioning

confidence: 99%

Impact of Clinical Pharmacist Intervention on Medication Adherence and Disease related Knowledge among Patients with Low Health Literacy in Puerto Rico

Santiago¹,

Melin²

2015

J Pharma Care Health Sys

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“…A literacia em saúde, ou as "competências cognitivas e sociais e a capacidade dos indivíduos para ganharem acesso a compreenderem e a usarem informação de formas que promovam e mantenham boa saúde" 31 é um possível mecanismo explicativo da relação entre o nível educacional e as desigualdades em saúde. Revelou estar associada em vários estudos com menores conhecimentos sobre a diabetes, 32 baixa adesão não intencional à terapêutica na diabetes 33 e constituir uma barreira na acessibilidade aos serviços e informação de saúde e aos meios de prevenção. 34 O rendimento também se associou à desigualdade observada mas com menor efeito.…”

Section: Discussionunclassified

“…Results: Diabetes was found to be concentrated among the people with lower educational levels (concentration index = -0.26) and lower income quintiles (concentration index = -0.14). Relative index of inequality also showed a lower degree of inequality among the most educated (0,20; CI 95% = [0,12; 0,32]) and with higher income (0,59; CI 95% = [0,48; 0,74]). Discussion: Distribution of diabetes is associated with education and income.…”

mentioning

confidence: 94%

Diabetes: Socioeconomic Inequalities in the Portuguese Population in 2014

et al. 2017

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Diabetes is a major public health problem and it is related to socioeconomic factors. The aim of this study is to describe socioeconomic inequalities in the distribution of diabetes in the population with 25 years or more, resident in Portugal in 2014. Material and Methods:Data from the Health National Survey 2014 was analysed, n = 16 786. We estimated the prevalence of diabetes in the population and stratified by socioeconomic variables namely educational level and income. The extent of socioeconomic inequalities was assessed using concentration index and the relative index of inequality. Results: Diabetes was found to be concentrated among the people with lower educational levels (concentration index = -0.26) and lower income quintiles (concentration index = -0.14). Relative index of inequality also showed a lower degree of inequality among the most educated (0,20; CI 95% = [0,12; 0,32]) and with higher income (0,59; CI 95% = [0,48; 0,74]). Discussion: Distribution of diabetes is associated with education and income. Previous studies have shown that although income might reflect lifestyle patterns, education reflects better social factors that are important for establishing healthier behaviours. Also, the National Health Service, of universal coverage and free of charge, might have contributed to reduce inequalities in the access to health by those with the lowest income. Conclusion: Supporting 'Health in All Policies' might reduce inequalities, namely by improving population educational level and actions that promote health literacy.

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“…A recent paper has identified that health literacy is still only marginally addressed in different aspects of work [46]. Low literacy is related to poor knowledge and may impact on health outcomes [47,48]. A study of 280 adults with poor glycaemic control showed that those with low health literacy perceived that their diabetes control was good when it was not [49].…”

Section: Health Literacymentioning

confidence: 99%

Discussion of Challenges in Engaging Urdu/Punjabi Speak People with Type 2 Diabetes in Structured Group Patient Education Using Interpretation and Established Educational Tools in Two Health Boards in Scotland

McDowell¹

2016

Int Arch Nurs Health Care

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IntroductionPeople from black and minority ethnic (BME) communities who live in upper-middle and high income countries [1] are at higher risk of type 2 diabetes than white Caucasians and they develop this at lower clinical points than white Caucasians [2,3]. A Scottish survey found that Scottish Pakistani and Indian people with type 2 diabetes were more likely to have poor diabetes control compared to white Scottish people with type 2 diabetes [4] and the Scottish Diabetes Action Plan (2010) aimed to address these inequities [5].Scotland's health is managed through 14 Boards and each Board has a disease specific Managed Clinical Network (MCN). The BME population in Scotland is concentrated mainly in the large cities of Glasgow, Edinburgh, Aberdeen and Dundee, spanning 4 of the 14 MCNs with smaller numbers dispersed across the rest of Scotland. The BME Scottish population is 4% [6] and the largest category is from Asia (3%) [6].Education and information, as well as being tailored to individuals' culture and beliefs, have been identified as two of the key themes necessary to support self-management for people with long-term-conditions [7]. MCNs within each Health Board are responsible for ensuring that culturally appropriate care is provided for people from the BME communities.Culturally appropriate care is defined as 'health education tailored to the cultural or religious beliefs and linguistic and literacy skills of the community being studied' [8]. A literature review identified two aspects to culturally appropriate care: one focuses on values, beliefs, traditions and language of a people group that may not meet the specific needs of individuals [9]. The second approach explains an individual's health status according to their social status rather than by their beliefs and behaviours. This second approach is considered as cultural safety and there is limited evidence of its use in health care. This paper considers culturally appropriate care within the context of language, beliefs and traditions. AbstractAim: Structured patient education is one aspect of supporting selfmanagement for people with diabetes. People from the black and minority ethnic groups who live in upper-middle and high income countries are at higher risk of developing type 2 diabetes mellitus than white Caucasians and providing structured patient education in a multicultural society can be challenging for practitioners. To promote a sustainable model of care, with language support, this paper discusses the use of culturally appropriate structured patient education with established tools within routine care.Methods: Structured patient education was provided for people with type 2 diabetes from the Urdu/Punjabi speaking communities in two Health Boards in Scotland during 2013 with language support. Diabetes Nurse Specialists and Practice Nurses with expertise in delivering structured patient education delivered Conversation Maps TM , as part of routine care, using Linkworkers in Lothian Health Board and Interpreters in Greater Glasgow and Clyde ...

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Update on Health Literacy and Diabetes

Cited by 254 publications

References 78 publications

Impact of Clinical Pharmacist Intervention on Medication Adherence and Disease related Knowledge among Patients with Low Health Literacy in Puerto Rico

Impact of Clinical Pharmacist Intervention on Medication Adherence and Disease related Knowledge among Patients with Low Health Literacy in Puerto Rico

Diabetes: Socioeconomic Inequalities in the Portuguese Population in 2014

Discussion of Challenges in Engaging Urdu/Punjabi Speak People with Type 2 Diabetes in Structured Group Patient Education Using Interpretation and Established Educational Tools in Two Health Boards in Scotland

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