Luis Puente-Maestu1, Myriam Calle2, Juan Luis Rodríguez-Hermosa2, Anna Campuzano3, Javier de Miguel Díez4, Jose Luis Álvarez-Sala2, Luis Puente-Andues5, Maria Joselín Pérez-Gutiérrez3, Shoou-Yih D Lee6. 1. Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Instituto de investigación Sanitaria Gregorio Marañón, Facultad de Medicina Universidad Complutense, Madrid, Spain. Electronic address: Lpuente@separ.es. 2. Servicio de Neumología, Hospital Clínico San Carlos, Madrid, Spain; Facultad de Medicina, Universidad Complutense, Madrid, Spain. 3. Ferrer International Laboratorios, Spain. 4. Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Instituto de investigación Sanitaria Gregorio Marañón, Facultad de Medicina Universidad Complutense, Madrid, Spain. 5. Instituto de investigación Sanitaria Gregorio Marañón, Spain. 6. Department of Health Policy and Management, School of Global Public Health, University of North Carolina, Chapel Hill, USA.
Abstract
BACKGROUND: There is little information worldwide about the impact of health literacy (HL) on clinical outcomes of COPD. Our aim was to quantify inadequate HL in Spain, as measured by the Short Assessment of Health Literacy for Spanish Adults questionnaire, and to examine the associations between HL and both COPD outcomes and health status. METHODS: 296 COPD patients of 68(SD = 9) years and a FEV1%predicted of 53%(SD = 18%) were enrolled and followed-up for one year. 59% showed "inadequate" HL. RESULTS: Individuals with inadequate HL were older (70[SD = 9] vs 65[SD = 8] years; p < 0.001) and had less knowledge of their disease, as measured by the low HL-COPD questionnaire, (6.9[SD = 2.3] vs 7.5[SD = 1.9]; p < 0.001). While their lung function was no different, they reported significant differences in mMRC (1.6[SD = 1] vs 1.4[SD = 1]; p < 0.001), CAT (19.2[SD = 8.1] vs 18.3[SD = 7.5]; p = 0.049), and EQ-5 (3.1[SD = 2.2] vs 2.3[SD = 1.9]; p < 0.00). Those with inadequate HL had also higher risk of having ≥2 comorbidities (OR = 1.87; 95%CI = 1.14-3.08), need of assistance (OR = 2.5; 95%CI = 1.5-4.2), anxiety/depression (OR = 1.9; 95%CI = 1.2-3.0), admissions or visits to the emergency department (OR = 1.70; 95%CI = 1.1-2.7), and all-cause deaths in the following year (3.8% (SE = 1.1%) vs 0%; p = 0.051). CONCLUSIONS: Inadequate HL is prevalent among COPD patients and it is related to health status and relevant clinical outcomes of the disease. HL needs to be considered when planning the care for COPD patients.
BACKGROUND: There is little information worldwide about the impact of health literacy (HL) on clinical outcomes of COPD. Our aim was to quantify inadequate HL in Spain, as measured by the Short Assessment of Health Literacy for Spanish Adults questionnaire, and to examine the associations between HL and both COPD outcomes and health status. METHODS: 296 COPDpatients of 68(SD = 9) years and a FEV1%predicted of 53%(SD = 18%) were enrolled and followed-up for one year. 59% showed "inadequate" HL. RESULTS: Individuals with inadequate HL were older (70[SD = 9] vs 65[SD = 8] years; p < 0.001) and had less knowledge of their disease, as measured by the low HL-COPD questionnaire, (6.9[SD = 2.3] vs 7.5[SD = 1.9]; p < 0.001). While their lung function was no different, they reported significant differences in mMRC (1.6[SD = 1] vs 1.4[SD = 1]; p < 0.001), CAT (19.2[SD = 8.1] vs 18.3[SD = 7.5]; p = 0.049), and EQ-5 (3.1[SD = 2.2] vs 2.3[SD = 1.9]; p < 0.00). Those with inadequate HL had also higher risk of having ≥2 comorbidities (OR = 1.87; 95%CI = 1.14-3.08), need of assistance (OR = 2.5; 95%CI = 1.5-4.2), anxiety/depression (OR = 1.9; 95%CI = 1.2-3.0), admissions or visits to the emergency department (OR = 1.70; 95%CI = 1.1-2.7), and all-cause deaths in the following year (3.8% (SE = 1.1%) vs 0%; p = 0.051). CONCLUSIONS: Inadequate HL is prevalent among COPDpatients and it is related to health status and relevant clinical outcomes of the disease. HL needs to be considered when planning the care for COPDpatients.
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