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Analysis suggests assessing health literacy would reduce deaths from heart failure

Kathleen Blanchard's picture
Heart failure

Assessing a patient's basic understanding of health information and services could save lives from heart failure, find investigators from Denver Health Medical Center. Researchers studied the effect of low health literacy on death rates associated with congestive heart failure - a condition that requires self-management including fluid and salt restriction, weighing daily and strict medication compliance.

One in five heart failure patients unable to process basic health information

According to information included in the study, published in JAMA, one in three Medicare recipients cannot obtain, process and understand basic health information. Among patients in the heart failure analysis, one in five patients were found to have low health literacy, putting them at high risk of dying from the complex disease.

Patients with heart failure experience frequent hospitalization and higher mortality from all causes. Pamela N. Peterson, M.D., M.S.P.H of the Denver Health Medical Center and colleagues assessed the impact on mortality and low health literacy in Medicare recipients with heart failure.

The study included 2,156 survey recipients. Among the 1,494 respondents, 17.5 percent had low health literacy and additional co-morbidities such as diabetes, stroke, lung disease and hypertension and older age. They were also more likely to have lower socioeconomic status and lack high school education.

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Follow-up, that was just over a year, found there were 124 deaths -17.6 percent of those were associated with lack of understanding about how to manage the disease versus 6.3 percent mortality in the group with adequate health literacy. Hospitalization rates were also higher among congestive heart failure patients with inadequate understanding of basic health information.

The authors concluded, “this study demonstrates that even among those with health insurance and access to health information, low health literacy as assessed by 3 brief screening questions is associated with higher mortality. This finding supports efforts to determine whether interventions to screen for and address low health literacy can improve important health outcomes in patients with heart failure."

The analysis shows one in five patients cannot manage their disease because they lack the inability to understand their disease. The study suggests the result is higher mortality rates and frequent hospitalization. The authors write, …”an adequate level of health literacy is likely critical in ensuring patient compliance and proficiency in self-management” of heart failure. Routine assessment of health literacy status could lower the number of deaths from all causes among Medicare recipients diagnosed with the disease.

JAMA: 2011;305(16):1695-1701. doi:10.1001/jama.2011.512
Health Literacy and Outcomes Among Patients With Heart Failure
Pamela N. Peterson, MD, MSPH et al.

Image credit: Morgue File