Health literacy and health outcomes in very old patients with heart failure

León-González, Rocío and García-Esquinas, Esther and Paredes-Galán, Emilio and Ferrero-Martínez, Ana Isabel and González-Guerrero, José-Luis and Hornillos-Calvo, Mercedes and Menéndez-Colino, Rocío and Torres-Torres, Ivett and Galán, María Concepción and Torrente-Carballido, Marta and Olcoz-Chiva, Mayte and Rodriguez Pascual, Carlos and Rodríguez-Artalejo, Fernando (2018) Health literacy and health outcomes in very old patients with heart failure. Revista Española de Cardiología (English Edition), 71 (3). pp. 178-184. ISSN 0300-8932

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Abstract

INTRODUCTION AND OBJECTIVES:
Health literacy (HL) has been associated with lower mortality in heart failure (HF). However, the results of previous studies may not be generalizable because the research was conducted in relatively young and highly-educated patients in United States settings. This study assessed the association of HL with disease knowledge, self-care, and all-cause mortality among very old patients, with a very low educational level.
METHODS:
This prospective study was performed in 556 patients (mean age, 85 years), with high comorbidity, admitted for HF to the geriatric acute-care unit of 6 hospitals in Spain. About 74% of patients had less than primary education and 71% had preserved systolic function. Health literacy was assessed with the Short Assessment of Health Literacy for Spanish-speaking Adults questionnaire, knowledge of HF with the DeWalt questionnaire, and HF self-care with the European Heart Failure Self-Care Behaviour Scale.
RESULTS:
Disease knowledge progressively increased with HL; compared with being in the lowest (worse) tertile of HL, the multivariable beta coefficient (95%CI) of the HF knowledge score was 0.60 (0.01-1.19) in the second tertile and 0.87 (0.24-1.50) in the highest tertile, P-trend = .008. However, no association was found between HL and HF self-care. During the 12 months of follow-up, there were 189 deaths. Compared with being in the lowest tertile of HL, the multivariable HR (95%CI) of mortality was 0.84 (0.56-1.27) in the second tertile and 0.99 (0.65-1.51) in the highest tertile, P-trend = .969.
CONCLUSIONS:
No association was found between HL and 12-month mortality. This could be partly due to the lack of a link between HL and self-care.

Keywords:Health literacy, Educational level, Self-care, Mortality
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Science > School of Pharmacy
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ID Code:27871
Deposited On:18 Jul 2017 14:48

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