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Health literacy and coronary artery disease: A systematic review
Gabriela Lima de Melo Ghisi1, Gabriela Suéllen da Silva Chaves2, Raquel Rodrigues Britto2
1Cardiovascular Prevention and Rehabilitation Program, University Health Network, Toronto Rehabilitation Institute, Toronto, Canada.
Insights
Approximately 30.5% of coronary artery disease (CAD) patients have low health literacy (HL), which is linked to poorer health behaviors and outcomes like hospital readmissions and lower quality of life.
Area of Science:
- Cardiology
- Health Literacy Research
- Patient Outcomes
Background:
- Health literacy (HL) is crucial for managing chronic conditions like coronary artery disease (CAD).
- Understanding the prevalence, predictors, and impact of low HL in CAD patients is essential for improving care.
- Existing literature on HL in this population is limited.
Purpose of the Study:
- To identify health literacy screening instruments for CAD patients.
- To determine the prevalence and predictors of low health literacy in CAD.
- To examine the association between health literacy, health behaviors, and patient outcomes.
Main Methods:
- A comprehensive literature search was performed on electronic databases up to February 2017.
- Included studies assessed health literacy in CAD patients, examining health behaviors and outcomes.
- Ten articles, including two RCTs, were analyzed for quality and findings.
Main Results:
- The REALM and TOFHLA instruments were most frequently used for HL screening.
- An average prevalence of 30.5% for low health literacy was observed in CAD patients.
- Low HL was associated with older age, male gender, non-white ethnicity, comorbidities, lower education, disadvantaged socioeconomic status, unemployment, hospital readmissions, low HRQoL, anxiety, and reduced social support.
Conclusions:
- The body of research on health literacy in coronary artery disease patients is notably scarce.
- Healthcare providers should implement strategies to address and mitigate the adverse effects of low health literacy in CAD patient care.
Objective:
Identify health literacy (HL) screening instruments available to CAD patients; describe the prevalence of low HL; explore the predictors of low HL; and, identify the association between HL, health behaviors, and outcomes among these patients.
Methods:
A literature search of electronic databases was conducted for published articles from database inception to February 2017. Eligible articles included the assessment of HL in CAD patients. Health behaviors and outcomes included diet, exercise, smoking, medication use, hospital readmission, knowledge, health-related quality of life (HRQoL), and psychosocial indicators.
Results:
Overall, ten articles were included, of which two were RCTs, and seven were considered "good" quality. The most used screening instruments were REALM and TOFHLA. The average prevalence of low HL was 30.5%. Low HL participants were more likely to be older, male, from a non-white ethnic group, have many CVD comorbidities, lower educational level, disadvantaged socioeconomic position, and less likely to be employed. Low HL was consistently associated with hospital readmissions, low HRQoL, higher anxiety and lower social support.
Conclusion:
The literature on HL in CAD patients is very limited.
Practice Implications:
Healthcare providers should start adopting strategies that can potentially mitigate the impact of low HL in the care of CAD patients.
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