How health literacy can impact heart failure patients
Low health literacy is associated with poor outcomes among heart failure (HF) patients, according to a new systematic review published in JACC: Heart Failure. The study's authors emphasized the importance of interventions such as patient communication and education.
“HF requires complex management skills such as monitoring weight and blood pressure, glycemia control, drug and diet adherence, and sometimes exercise and weight loss,” wrote lead author Matteo Fabbri, MD, department of health sciences research at Mayo Clinic in Rochester, Minnesota, and colleagues. “Thus, greater attention has been directed toward health literacy, which is important for managing a chronic condition such as HF.”
Fabbri and colleagues analyzed findings from 15 previous studies that evaluated the health literacy of adult HF patients who weren’t using a left ventricular assist device. The studies evaluated more than 9,000 patients overall, and 24% of those patients had “inadequate or marginal health literacy.” Inadequate health literacy was associated with a higher unadjusted risk of death, hospitalization and vising the emergency department. The adjusted figures still revealed an association between inadequate health literacy and a higher risk of death and hospitalization.
In addition, the authors noted, two of the studies they assessed found that patient outcomes could be improved by boosting health literacy. Interventions explored in those studies included one-hour educational sessions, phone calls, medication counseling and more.
“The mechanism that links health literacy and outcomes is complex and likely involves other social determinants of health,” the authors wrote. “Some studies mentioned that these patients are less likely to access health care services, and, when they do, they are less likely to engage in effective physician-patient communication.”
A patient’s choice not to engage may be due to “feelings of shame,” the team added, and “it is essential to purse any opportunity to improve outcomes.”
“Identifying health literacy as a factor that affects health outcomes and measuring its effect on patients with HF is essential to allocate more resources for, and research on, interventions to improve health literacy,” study co-author Lila J. Finney Rutten, PhD, a professor at Mayo Clinic, added in a prepared statement.