The association of health literacy with adherence and outcomes in moderate-severe asthma
Autor: | Jason Roy, Rodalyn Gonzalez, Cynthia S. Rand, Chantel Priolo, Fei Wan, Andrea J. Apter, Ian M. Bennett, Daniel K. Bogen, Thomas R. Ten Have, Knashawn H. Morales, Susan Reisine, Bruce G. Bender, Tyra Bryant-Stephens |
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Rok vydání: | 2013 |
Předmět: |
Adult
Male medicine.medical_specialty Pediatrics media_common.quotation_subject Immunology Psychological intervention Health literacy Article Literacy Medication Adherence Cohort Studies Quality of life Adrenal Cortex Hormones Surveys and Questionnaires Internal medicine Administration Inhalation Humans Immunology and Allergy Medicine Prospective Studies Prospective cohort study media_common Asthma business.industry Hispanic or Latino Emergency department Middle Aged medicine.disease Health Literacy Respiratory Function Tests respiratory tract diseases Black or African American Hospitalization Self Care Quality of Life Female business Cohort study |
Zdroj: | Journal of Allergy and Clinical Immunology. 132:321-327 |
ISSN: | 0091-6749 |
DOI: | 10.1016/j.jaci.2013.02.014 |
Popis: | Low health literacy is associated with poor outcomes in asthma and other diseases, but the mechanisms governing this relationship are not well defined.We sought to assess whether literacy is related to subsequent asthma self-management, measured as adherence to inhaled steroids, and asthma outcomes.In a prospective longitudinal cohort study, numeric (Asthma Numeracy Questionnaire) and print literacy (Short Test of Functional Health Literacy in Adults) were assessed at baseline in adults with moderate or severe asthma for their impact on subsequent electronically monitored adherence and asthma outcomes (asthma control, asthma-related quality of life, and FEV1) over 26 weeks, using mixed-effects linear regression models.A total of 284 adults participated: age, 48 ± 14 years, 71% females, 70% African American, 6% Latino, mean FEV1 66% ± 19%, 86 (30%) with hospitalizations, and 148 (52%) with emergency department visits for asthma in the prior year. Mean Asthma Numeracy Questionnaire score was 2.3 ± 1.2 (range, 0-4); mean Short Test of Functional Health Literacy in Adults score was 31 ± 8 (range, 0-36). In unadjusted analyses, numeric and print literacy were associated with better adherence (P = .01 and P = .08, respectively), asthma control (P = .005 and P.001, respectively), and quality of life (P.001 and P.001, respectively). After controlling for age, sex, and race/ethnicity, the associations diminished and only quality of life (numeric P = .03, print P = .006) and asthma control (print P = .005) remained significantly associated with literacy. Race/ethnicity, income, and educational attainment were correlated (P.001).While the relationship between literacy and health is complex, interventions that account for and address the literacy needs of patients may improve asthma outcomes. |
Databáze: | OpenAIRE |
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