Why health literacy is important for heart failure patients

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New York  Patients with heart failure who experience low health literacy are at an increased risk of hospitalisation and mortality, according to a new study.

Heart failure is a chronic condition that requires patients to engage in complex self-management skills to monitor weight and blood pressure, control glycaemia, stick to drug and diet guidelines and occasionally lose weight and exercise.

Therefore, greater attention has recently been given to health literacy, which is defined by the authors of the study as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.”

“Our findings showed that an inadequate level of health literacy is associated with increased risks in mortality and hospitalisation among patients with heart failure,” said study author Lila J. Finney Rutten from the Mayo Clinic in the US.

Previous studies have suggested that low health literacy among patients with heart failure could be associated with higher risk of mortality, hospitalisations and emergency department visits, but the results have been inconsistent.

For the current findings, published in the journal ‘JACC: Heart Failure’, the research team conducted a systematic review across EMBASE, MEDLINE, PsycInfo and EBSCO CINAHL databases from inception to January 1, 2019.

Both observational and interventional studies evaluated the impact of health literacy among patients 18 years or older with heart failure on mortality, hospitalisations and emergency department visits for all causes.

Interventional studies evaluated interventions among patients with heart failure who had low health literacy. Among the observational studies, 9,171 heart failure patients were included, of which 2,207 (24 per cent) had inadequate or marginal health literacy.

The researchers found that low health literacy was associated with higher unadjusted risk for mortality, hospitalisation and emergency department visits. In adjusted analyses, low health literacy remained statistically associated with mortality and hospitalisation, but no correlation was found for emergency department visits.

Among the four interventional studies, two effectively improved outcomes for heart failure patients with low health literacy. “Identifying health literacy as a factor that affects health outcomes and measuring its effect on patients with heart failure is essential to allocate more resources for, and research on, interventions to improve health literacy,” Rutten said.

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