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Health Literacy Linked to Survival

April 27, 2011

(Ivanhoe Newswire) — An examination of health literacy (such as understanding basic health information) among managed care patients with heart failure, a condition that requires self-management, found that nearly one in five have low health literacy, which was associated with a higher all-cause risk of death, according to a new study.

Health literacy is understanding, obtaining, and processing basic health information and services needed to make adequate health decisions. Many U.S. citizens and as many as 1 in 3 Medicare enrollees have low health literacy. Heart disease is a very common chronic disease with a high risk of illness and death.

“Although patients with heart failure are frequently hospitalized, much care for heart failure is performed on a daily basis by individual patients outside of the hospital. This self-care requires integration and application of knowledge and skills. Therefore, an adequate level of health literacy is likely critical in ensuring patient compliance and proficiency in self-management. Little is known about the association between health literacy and outcomes among patients with heart failure,” the authors were quoted as saying.

Pamela N. Peterson, M.D., M.S.P.H., of the Denver Health Medical Center and colleagues evaluated the association between low health literacy and all-cause mortality and hospitalization among a population of outpatients with heart failure.

Of the 2,156 patients surveyed, 1,547 responded. Of 1,494 included responders, 262 (17.5 percent) had low health literacy. Patients with low health literacy were older, of lower socioeconomic status, and less likely to have at least a high school education. They were also more likely to have coexisting illnesses such as diabetes, hypertension, chronic pulmonary disease, and stroke.

There were a total of 124 deaths during follow-up, with 46 deaths (17.6 percent) in the low health literacy group. There were a total of 366 hospitalizations during follow-up, with 80 hospitalizations (30.5 percent) in the low health literacy group. After adjusting for demographic variables, socioeconomic status, education, comorbid conditions, year of cohort entry, and left ventricular ejection fraction (a measure of how well the left ventricle of the heart pumps with each contraction), low health literacy was independently associated with an increased risk of mortality. In adjusted models, low health literacy was not significantly associated with all-cause hospitalization.

The authors suggest that routine assessment of health literacy may help to identify a greater number of patients at risk for adverse outcomes.

SOURCE: JAMA, published online April 26, 2011




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