Wayne State University researchers publish study on Glaucoma Patients with Poor Health LiteracyMay 12, 2008
May Lead to Greater Disease Progression
"Health literacy, as a discrete form of literacy, is increasingly important in health care," according to background information in the article. "The U.S. Department of Health and Human Services defines health literacy 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'."
Mark S. Juzych, M.D., M.H.S.A., associate dean of Graduate Medical Education in the School of Medicine and professor of Ophthalmology at the Kresge Eye Institute at Wayne State University, and colleagues used a standardized test to determine the health literacy of 204 English-speaking patients treated for glaucoma for at least one year. Patients' demographic information and glaucoma understanding were assessed through an oral questionnaire.
Of the 204 glaucoma patients, half were categorized as having poor health literacy and the other half were categorized as having adequate health literacy.
"Being of white race, having an education of some college or more and having a household income of $20,000 or greater was associated with a lower likelihood of having poor health literacy," the authors wrote.
On average, the poor literacy group had lower glaucoma understanding, missed more appointments per year and reported having missed taking eye drops more frequently than those in the adequate literacy group, with 65 patients having missed taking eye drops two or more times per month compared with only 34 patients in the adequate literacy group. Patients with poor health literacy also showed greater visual field loss at the beginning of the study and significantly worse visual field parameters when comparing recent and initial visual fields.
"Closing the gap in health literacy is one essential component in reducing disparities in glaucoma care. Screening patients for poor literacy is a first step," Dr. Juzych and his colleagues conclude. "However, the real challenge is in shaping effective public health communication that is culturally and linguistically appropriate for patients and promotes compliance with medications and follow-up treatment with their physicians. In addition, there is a need to improve physician communication, which should consider the needs and competencies of patients with poor health literacy."
"Dr. Juzych and his research team are focusing on a crisis we face in public health today," commented Dr. Hilary Ratner, vice president for Research at Wayne State University. "The lack of health literacy can potentially have a devastating effect on the lives of many, as these groups are less likely to make use of disease prevention services or follow important treatment plans."
(Arch Intern Med. 2008;126:718-724. Available to the media at www.jamamedia.org.)
Editor's Note: This study was supported by the Penta Glaucoma Fund. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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