Disease Name Recognition and Prognosis in Older Patients With Heart Failure

Health literacy is considered a prognostic determinant for patients with heart failure (HF), and the recognition of disease names could be fundamental to this. This study examined the proportion of patients with HF who recognized their disease name and its association with prognosis.

From January 2021 to June 2023, 188 hospitalized patients with HF (Stage B-D, median age 81 years) were asked to recall their disease name before discharge. Recognition accuracy was evaluated using a standardized scoring system, and interobserver agreement was confirmed. In a subset, communicative and critical health literacy (CCHL) was assessed. Prognostic outcomes included all-cause mortality and all-cause hospitalization after discharge.

The recognition score showed high interobserver reliability (κ = 0.85). Seventy-two patients (38%) failed to recognize their primary diagnosis. Those without recognition had significantly lower CCHL scores than those with recognition (p < 0.01). During a median follow-up of 280 days, 76 patients (40%) experienced adverse events. In univariate analyses, lack of diagnosis recognition was associated with an increased risk of adverse outcomes, but this association disappeared after adjustment for age, cognitive function, and HF severity.

A substantial number of older patients with HF did not recognize their primary diagnosis, but disease recognition was not an independent determinant of prognosis.