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General and disease-specific health literacy in patients with heart failure: an outcome analysis

Klara Rebernik Grah1,2, Mitja Lainscak2,3, Jerneja Farkas1,2,3

  • 1National Institute of Public Health, Trubarjeva cesta 2, SI-1000 Ljubljana, Slovenia.

ESC Heart Failure
|July 23, 2026
PubMed

Insights

In heart failure patients, 22% had limited general health literacy. Disease-specific health literacy independently improved self-care behaviors, while general health literacy showed a trend toward poorer clinical outcomes.

Area of Science:

  • Cardiology
  • Health Literacy Research
  • Patient Outcomes

Background:

  • Health literacy is crucial for managing chronic conditions like heart failure (HF).
  • Understanding the nuances between general and disease-specific health literacy in HF patients is essential for targeted interventions.

Purpose of the Study:

  • To assess general and disease-specific health literacy in heart failure patients.
  • To investigate the relationship between health literacy and behavioral, patient-reported, and clinical outcomes in HF.

Main Methods:

  • Prospective observational study of 126 heart failure outpatients over six months.
  • Assessed general health literacy using the Brief Health Literacy Screen (BHLS) and disease-specific health literacy with the Heart Failure-Specific Health Literacy Scale (HFsHLS).

Main Results:

  • 22% of patients exhibited limited general health literacy, associated with lower education and higher NT-proBNP levels.
  • Both general and disease-specific health literacy correlated with better HF knowledge, quality of life, and self-rated health (univariable analysis).
  • Disease-specific health literacy independently predicted self-care behaviors, but neither measure was independently linked to clinical outcomes.

Conclusions:

  • Limited general health literacy affects a significant portion of heart failure patients.
  • General and disease-specific health literacy are distinct; disease-specific literacy is key for self-care behaviors.
  • A trend towards worse clinical outcomes was noted in patients with limited general health literacy.
Abstract

Keywords:
Clinical outcomeHealth literacyHeart failureLongitudinal studyOutpatient careSelf-care behaviours

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