Health literacy in familial hypercholesterolemia: A cross-national study

Abstract

Background High rates of inadequate health literacy are associated with maladaptive health outcomes in chronic disease including increased mortality and morbidity rates, poor treatment adherence and poor health. Adequate health literacy may be an important factor in the effective treatment and management of familial hypercholesterolemia, and may also be implicated in genetic screening for familial hypercholesterolemia among index cases. The present study examined the prevalence and predictors of health literacy in familial hypercholesterolemia patients attending clinics in seven countries. Design Cross-sectional survey. Methods Consecutive FH patients attending clinics in Australia, Brazil, China, Hong Kong, Malaysia, Taiwan and the UK completed measures of demographic variables (age, gender, household income and highest education level) and a brief three-item health literacy scale. Results Rates of inadequate health literacy were lowest in the UK (7.0%), Australia (10.0%), Hong Kong (15.7%) and Taiwan (18.0%) samples, with higher rates in the Brazil (22.0%), Malaysia (25.0%) and China (37.0%) samples. Income was an independent predictor of health literacy levels, accounting for effects of age. Health literacy was also independently related to China national group membership. Conclusions Findings indicate non-trivial levels of inadequate health literacy in samples of familial hypercholesterolemia patients. Consistent with previous research in chronic illness, inadequate health literacy is related to income as an index of health disparities. Chinese familial hypercholesterolemia patients are more likely to have high rates of inadequate health literacy independent of income. Current findings highlight the imperative of education interventions targeting familial hypercholesterolemia patients with inadequate health literacy.

Exploring Health Literacy in Patients with Chronic Diseases in Chongqing, China in 2018: A Cross-Sectional Study

“…The association between education and health literacy levels was the primary focus of this study, that is, health literacy is associated with educational level. This result is consistent with the survey on health literacy in familial hypercholesterolemia showing educational level-related variations in health literacy [24]. The participants with higher education possibly had additional learning opportunities and thus, additional knowledge.…”

“…Previous studies showed that the related health benefits and services of economically disadvantaged groups were less likely to be accessed than those of economically affluent groups [27,28]. Therefore, the income level is possibly one of the economic determinants linked to health literacy among patients with chronic diseases [24].…”

“…(1) Demographic and socioeconomic characteristics Sex (male/female), registered permanent residence (local/ nonlocal), residence (urban/rural), age (15)(16)(17)(18)(19)(20)(21)(22)(23)(24) years old/25-34 years old/35-44 years old/45-54 years old/55-64 years old/65-69 years old), nationality (Han nationals/minorities), marital status (unmarried/married), educational level (illiterate or slightly literate; primary school; secondary school; high school/vocational high school/technical secondary school; junior college/bachelor's degree or above), vocation (farmer/not farmer), the annual average family income (< 3,000 yuan/3,000-4,999 yuan/5,000-9,999 yuan/10,000-14,999 yuan/≥ 15,000 yuan) and self-rated health status (healthy/neutral/unhealthy).…”

Challenges in reducing atherosclerotic inflammation in patients with familial hypercholesterolemia

“…Accordingly, optimisation of anti-atherosclerotic strategies should rely on the inhibition of both risk factors to limit the residual risk demonstrated by currently used drugs. 34 In patients with FH, reduction of inflammatory risk seems to be harder to obtain than in other patients at increased cardiovascular risk, thus additional pathophysiological studies are warranted to clarify the peculiar ‘resistance’ of atherosclerotic inflammation in FH patients. 35 With this point of view, FH subjects could particularly benefit from the addition of selective anti-inflammatory compounds on top of the already recommended lipid-lowering drugs to blunt atherosclerotic burden and improve cardiovascular outcome.…”

Virtual genetic diagnosis for familial hypercholesterolemia powered by machine learning

“…In this study, we did not assess whether machine-learning models can replace the Dutch Lipid Score at a population level, which can be the subject of further studies as FH is probably underdiagnosed and untreated. 22,23…”