Sarah R Cox1, Michael G Liebl2, Meghan N McComb3, Jason Q Chau4, Allison A Wilson5, May Achi6, Kevin W Garey7, David Wallace8. 1. Department of Pharmacy, Houston Methodist Hospital, 6565 Fannin St., Houston, TX 77030, USA; University of Houston College of Pharmacy, 1441 Moursund Street, Houston, TX 77030, USA. Electronic address: sarah.cox127@gmail.com. 2. Department of Pharmacy, Houston Methodist Hospital, 6565 Fannin St., Houston, TX 77030, USA. Electronic address: mliebl@houstonmethodist.org. 3. Department of Pharmacy, Houston Methodist Hospital, 6565 Fannin St., Houston, TX 77030, USA. Electronic address: meghanmccomb@yahoo.com. 4. Department of Pharmacy, Houston Methodist Hospital, 6565 Fannin St., Houston, TX 77030, USA. Electronic address: jqchau@icloud.com. 5. Department of Pharmacy, Houston Methodist Hospital, 6565 Fannin St., Houston, TX 77030, USA. Electronic address: awilson@houstonmethodist.org. 6. Department of Pharmacy, Houston Methodist Hospital, 6565 Fannin St., Houston, TX 77030, USA. Electronic address: machi@houstonmethodist.org. 7. University of Houston College of Pharmacy, 1441 Moursund Street, Houston, TX 77030, USA. Electronic address: kgarey@uh.edu. 8. University of Houston College of Pharmacy, 1441 Moursund Street, Houston, TX 77030, USA. Electronic address: DWallace@uh.edu.
Abstract
BACKGROUND: Low health literacy increases the risk for hospital readmissions. Despite this, the measurement and use of health literacy to guide discharge counseling and planning in heart failure patients is not commonly performed. A short 3-Question Brief Health Literacy Screen (BHLS) is available and takes less than three minutes to complete, but has never been evaluated to help determine whether health literacy affects healthcare use after discharge in patients with heart failure. OBJECTIVE: The purpose of this study was to assess 30-day readmissions and emergency department visits based on health literacy evaluated by the BHLS in an acute care heart failure population. METHODS: This was a prospective observational cohort study conducted at a large quaternary health system. Hospitalized patients with a diagnosis of heart failure were assessed for health literacy using the BHLS. Unplanned healthcare use after discharge including 30-day, all-cause ED visits and hospital readmissions was assessed using univariate and logistic regression models. RESULTS: Two hundred and sixty four patients aged 66.6 ± 14.3 (mean ± SD) years met inclusion/exclusion criteria of whom 175 (66.3%) had a BHLS score >9 (adequate health literacy) and 89 (33.7%) had a BHLS score ≤9 (low health literacy). Predictors of low health literacy included older age (p = 0.019), lower education level (p < 0.001) and unemployed (p = 0.048). After controlling for potential confounders, low health literacy was independently associated with 30-day healthcare use after hospital discharge (OR:1.80; 95% CI: 1.04-3.11; p = 0.035). CONCLUSION: Using a short, 3-question validated survey instrument, it was demonstrated that low health literacy was associated with increased 30-day unplanned healthcare use after discharge in this heart failure population. These results provide a clinically useful, easily incorporated tool that could identify high-risk patients at need for clinical interventions.
BACKGROUND: Low health literacy increases the risk for hospital readmissions. Despite this, the measurement and use of health literacy to guide discharge counseling and planning in heart failurepatients is not commonly performed. A short 3-Question Brief Health Literacy Screen (BHLS) is available and takes less than three minutes to complete, but has never been evaluated to help determine whether health literacy affects healthcare use after discharge in patients with heart failure. OBJECTIVE: The purpose of this study was to assess 30-day readmissions and emergency department visits based on health literacy evaluated by the BHLS in an acute care heart failure population. METHODS: This was a prospective observational cohort study conducted at a large quaternary health system. Hospitalized patients with a diagnosis of heart failure were assessed for health literacy using the BHLS. Unplanned healthcare use after discharge including 30-day, all-cause ED visits and hospital readmissions was assessed using univariate and logistic regression models. RESULTS: Two hundred and sixty four patients aged 66.6 ± 14.3 (mean ± SD) years met inclusion/exclusion criteria of whom 175 (66.3%) had a BHLS score >9 (adequate health literacy) and 89 (33.7%) had a BHLS score ≤9 (low health literacy). Predictors of low health literacy included older age (p = 0.019), lower education level (p < 0.001) and unemployed (p = 0.048). After controlling for potential confounders, low health literacy was independently associated with 30-day healthcare use after hospital discharge (OR:1.80; 95% CI: 1.04-3.11; p = 0.035). CONCLUSION: Using a short, 3-question validated survey instrument, it was demonstrated that low health literacy was associated with increased 30-day unplanned healthcare use after discharge in this heart failure population. These results provide a clinically useful, easily incorporated tool that could identify high-risk patients at need for clinical interventions.
Authors: Matteo Fabbri; Kathleen Yost; Lila J Finney Rutten; Sheila M Manemann; Cynthia M Boyd; Daniel Jensen; Susan A Weston; Ruoxiang Jiang; Véronique L Roger Journal: Mayo Clin Proc Date: 2017-12-06 Impact factor: 7.616
Authors: Varun Ayyaswami; Divya Padmanabhan; Manthan Patel; Arpan Vaikunth Prabhu; David R Hansberry; Nitin Agarwal; Jared W Magnani Journal: Health Lit Res Pract Date: 2019-04-10