Low Health Literacy: Significant Factor For Death Of Patients With Acute Heart Failure

New study reveals that patients with acute heart failure can die within two years of hospital admission due to low health literacy rates. Failure to fully understand and execute the teachings that the health care providers impart to these patients are actually risks for death, according to experts.

As heart failure is a complicated medical condition, lead author Dr Candace D. McNaughton of Vanderbilt University in Nashville, Tennessee said that patients need to be take in a range of prescribed drugs, religiously measure salt intake, weigh daily and observe their signs and symptoms. To be able to do these things, one should not only have the necessary understanding, but the ability to put perplexing medical instructions into action accurately.

As published in their journal the American Heart Association, discovered that more than 30 percent of hospitalised patients with heart failure die or are readmitted. This data was collated after researchers monitored 1,379 patients with heart failure - taking into account their answers to a short health literacy test for their hospitalisations from 2010 to 2013. Demographic data, such as age, race, gender, educational background, insurance, comorbidities and length of hospital admission were also considered.

“Nurses asked patients three questions: whether they have problems learning about their medical condition, their confidence filling out medical forms and how often they have someone help them read hospital materials,” said McNaughton. This, she believes, is the first time that a study delved into the health literacy of patients admitted for acute heart failure.

The results showed that about 24 percent have low health literacy and approximately 30 percent have died by the time of their follow-up schedule. These number did not correlate to readmission and consultations made in the emergency department.

The link between health literacy and the prognosis of acute heart failure was neither confirmed nor clarified by the research, commented Dr Hector Bueno from the Hospital General Universitario Gregorio Marañón in Madrid, Spain. “In general, the level of understanding of the causes, mechanism and course of the disease, triggers of decompensation and the role drugs and how these should be adjusted according to different situations required for an optimal self-care needs to be higher than for other chronic diseases,” Bueno, who was not involved in the study told Reuters Health via email. “One other important factor is that, compared with other chronic diseases -- i.e. diabetes mellitus -- heart failure is more frequent in elderly patients and we know that the level of general literacy is lower in older individuals,” he added.

Patients and healthcare providers should have continuous communication regarding the specific information involved in the treatment plan, McNaughton recommended. Sometimes, the members of the healthcare team often overlook the abilities of the patients to understand healthcare information. This is because it is hard to identify those who can and cannot understand fully, as even patients with college degrees who did not major in the sciences can have a hard time understanding medical data. But McNaughton iterated that the health literacy of patients with acute heart failure can be determined with just three questions -- the ones used by the nurses in the study. “Really, though, all medical conditions require health literacy -- everything from allergies to high blood pressure,” she explained. “Health literacy or the ability to use and understand healthcare information, is important for all patients, but the stakes are very high for patients with heart failure.”

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