Cardiovascular disease risk and secondary prevention of cardiovascular disease among patients with low health literacy

Abstract

ObjectiveTo explore the association between health literacy and the risk of cardiovascular disease (CVD), and to assess the differential effects by health literacy level of a nurse-coordinated secondary prevention program (NCPP) in patients with coronary artery disease (CAD).MethodsData were collected in two medical centres participating in the RESPONSE trial (Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists). CVD risk profiles were assessed at baseline and 12-month follow-up using the Systematic Coronary Risk Evaluation (SCORE). Health literacy was assessed by the short Rapid Estimate of Adult Literacy in Medicine (REALM-D) and the Newest Vital Sign (NVS-D); self-reported health literacy was evaluated by the Set of Brief Screening Questions (SBSQ-D).ResultsAmong 201 CAD patients, 18% exhibited reading difficulties, 52% had difficulty understanding and applying written information, and 5% scored low on self-reported health literacy. Patients with low NVS-D scores had a higher CVD risk [mean SCORE 5.2 (SD 4.8) versus 3.3 (SD 4.1), p < 0.01]. Nurse-coordinated care seemed to reduce CVD risk irrespective of health literacy levels without significant differences.ConclusionInadequate health literacy is prevalent in CAD patients in the Netherlands, and is associated with less favourable CVD risk profiles. Where many other forms of CVD prevention fail, nurse-coordinated care seems to be effective among patients with inadequate health literacy.

Association between education and major adverse cardiac events among patients with acute coronary syndrome in the Arabian Gulf

“…A nurse-coordinated intervention carried out in the Netherlands for patients with CAD appears to be effective among patients with poor health literacy. It involved four patient visits with a trained nurse focusing on promoting healthy lifestyles, managing biometric risk factors and increasing medication adherence and resulted in similar reductions in CVD risk profiles regardless of level of health literacy 27. This promising initiative could be adapted and tested for patients with CVD in the Arabian Gulf; this is particularly important since nearly half of the patients are illiterate.…”

Health literacy in Italy: a cross-sectional study protocol to assess the health literacy level in a population-based sample, and to validate health literacy measures in the Italian language

“…HL levels will be assessed in a population-based sample via use of a validated measure (NVS-IT), which has been applied in different countries and contexts 25–30 32 and has also been used in the HLS-EU. 6 This will allow for systematic comparison of data with those obtained in the eight countries involved in the European survey.…”

Development and feasibility testing of an avatar‐based education application for patients with acute coronary syndrome

“…Around 59% of Australians aged 15-47 have been identified as having below adequate health literacy (Australian Institute of Health and Welfare 2016). People with low health literacy are more likely to have poorer health knowledge, lower self-efficacy and less engagement in self-care (Macabasco-O'Connell et al, 2011;van Schaik et al, 2017). Innovative interventions for patient education have been reported to provide more engaging education and to improve self-care knowledge and behaviour, particularly for people with low health literacy levels (Bickmore, Pfeifer, & Paasche-Orlow, 2009;Clark et al, 2015).…”