Low health literacy cause for concern among patients with HF

Peterson PN. JAMA. 2011;305:1695-1701.

Retrospective cohort study data have shown that among patients with HF, low health literacy correlated with a significantly higher risk for all-cause mortality. This, however, did not translate to an increased risk for hospitalization.

Pamela N. Peterson, MD, MSPH, and a group of researchers conducted the study by surveying outpatients with HF enrolled at Kaiser Permanente of Colorado. All patients (n=2,156) were diagnosed from 2001 to 2008 and were mailed a survey that consisted of three brief questions assessing health literacy skill, from which they were graded on a five-point scale.

Of those surveyed, 1,547 responded and 1,494 were included in the final analysis. Overall, 262 patients had low health literacy. Characteristics that identified patients as having low health literacy included old age, higher rates of coexisting illnesses and low socioeconomic status.

During the 1.2-year median follow-up, 124 deaths were reported, with a significantly higher rate found in the low health literacy group vs. the adequate health literacy group (17.6% vs. 6.3%; adjusted HR=1.97; 95% CI, 1.3-2.97). Despite this finding, rates of hospitalization were only modestly higher in the low literacy group and did not reach statistical significance (30.5% vs. 23.2%; adjusted HR=1.05, 95% CI, 0.8-1.37).

According to the researchers, the study’s finding “supports efforts to determine whether interventions to screen for and address low health literacy can improve important health outcomes in patients with HF.”

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