Limited Health Literacy Is Associated With Worse Patient-Reported Outcomes in Inflammatory Bowel Disease

Tormey, Lauren K.; Reich, Jason; Chen, Yu Sarah; Singh, Achint K.; Lipkin-Moore, Zachary; Yu, Anzhu; Weinberg, Janice; Farraye, Francis A.

doi:10.1093/ibd/izy237

Cited by 43 publications

(50 citation statements)

References 61 publications

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“…For example, it may affect the ability of patients to follow written instructions for medications (28) or engage in self-care, and it has been linked to nonadherence to medications (9). The association of limited health literacy with worse scores on patient-reported outcomes noted in the study of patients with IBD also found that patients with limited health literacy had more symptoms of active disease (26). In RA, limited health literacy has been associated with health outcomes, poorer functional status, and more health care use (9,10,29).…”

Section: Discussionmentioning

confidence: 99%

“…For example, low health literacy was associated with large, clinically significant decrements in Health Assessment Questionnaire scores among a large cohort of individuals with RA, even after accounting for educational attainment (9). Likewise, limited health literacy was associated with lower ratings of health status and quality of life among individuals with inflammatory bowel disease (IBD) (26). Other investigators have proposed that health literacy may at least partially mediate educational and racial/ethnic disparities in some health outcomes (27), but we found only limited evidence of such mediation in our analyses because low education was much less frequently associated with the patient‐reported outcomes, even without considering health literacy; i.e., there was little effect of low education to be mediated.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Limited Health Literacy on Patient‐Reported Outcomes in Systemic Lupus Erythematosus

Katz

Dall’Era

Trupin

et al. 2020

Arthritis Care & Research

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Objective. Health disparities in patient-reported outcomes by income and education are well documented; however, the impact of health literacy on patient-reported outcomes has received less attention. We examined independent effects of income, education, and health literacy on patient-reported outcomes in systemic lupus erythematosus (SLE). Methods. Data from the California Lupus Epidemiology Study (n = 323 participants) were used. Health literacy was assessed with a validated 3-item measure (ability to understand written information, reliance on others to understand written information, confidence in completing written forms). Patient-reported outcomes were administered by interview in English, Spanish, Cantonese, or Mandarin. Generic and disease-specific patient-reported outcomes were examined using the following: 10 Patient-Reported Outcomes Measurement Information System (PROMIS) short forms; the 8 Short Form 36 (SF-36) health survey subscales; and 3 patient-reported SLE disease activity and damage measures. We conducted 2 sets of multivariable analyses: the first examined education, income, or health literacy individually; the second included all 3 simultaneously. All multivariable models included age, sex, race/ ethnicity, language, disease duration, and physician-assessed disease activity and damage. Results. More than one-third of participants (38%) had limited health literacy (LHL), including >25% with greater than high school education. In multivariable analyses simultaneously considering education, income, and health literacy, LHL was associated with significantly worse scores on all patient-reported outcomes except disease damage. In contrast, disparities by income were seen in only 3 PROMIS scales, 3 SF-36 subscales, and 1 disease activity measure. No disparities by education level were noted. Conclusion. We found significantly worse patient-reported outcome scores among individuals with LHL, even after controlling for disease activity and damage. Whether disparities are due to actual differences in health or measurement issues requires further study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of Limited Health Literacy on Patient‐Reported Outcomes in Systemic Lupus Erythematosus

Katz

Dall’Era

Trupin

et al. 2020

Arthritis Care & Research

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“…Patients with lower health literacy are more likely to be noncompliant with treatment and to report higher unmet informational needs and more mental distress, which may contribute to overall poorer QOL. 35,36,44,45 Early intervention to improve patient understanding and health literacy, therefore, may improve patient QOL not only during but after treatment. Prior research has shown that interventions to improve health literacy resulted in a higher rate of patient adherence to treatment.…”

Section: Discussionmentioning

confidence: 99%

Health literacy: Impact on quality of life in head and neck cancer survivors

et al. 2019

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Objectives Although inadequate health literacy has been shown to impact health outcomes in other cancers, little is known about its impact in head and neck cancer (HNC). This study aimed to determine the prevalence and predictors of inadequate health literacy and evaluate the association between health literacy and quality of life (QOL) in HNC survivors. Methods We conducted a retrospective analysis of HNC survivors evaluated in a multidisciplinary HNC survivorship clinic. Survivors had to be ≥1‐year postcompletion of treatment to be included in the analysis. Health literacy was assessed via self‐report with the Brief Health Literacy Screen (score <10 indicating inadequate health literacy), and QOL was measured using the University of Washington QOL questionnaire. Linear regression with robust standard errors was utilized to evaluate the association between health literacy and QOL. Results Of the 218 survivors evaluated, 13.8% (n = 30) demonstrated inadequate health literacy. After adjusting for age, marital status, site, stage, treatment modality, and years since treatment completion, social–emotional QOL scores for survivors with adequate health literacy were estimated to be 10.67 points higher than those with inadequate health literacy (P = .013). Health literacy was not significantly associated with physical QOL after adjusting for covariates (P = .130). Conclusion Inadequate health literacy is associated with a lower social QOL in HNC survivors, and among those with inadequate health literacy, interventions to ameliorate the impact on QOL are needed. Level of Evidence 4 Laryngoscope, 130:2354–2359, 2020

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“…The authors noted that Crohn's disease patients with limited health literacy have more symptoms of active disease, more depression, and worse overall health status. 1 Low health literacy has been associated with difficulty managing chronic conditions, decreased medication adherence, and more hospitalizations. 2,3 Additionally, there are simple health literacy screening tools that can be easily administered.…”

Section: To the Editorsmentioning

confidence: 99%

Health Literacy Assessments May Be Inconsistently Conducted in IBD Patients

Borum

Taneja

Corinaldi

2019

Inflammatory Bowel Diseases

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Limited Health Literacy Is Associated With Worse Patient-Reported Outcomes in Inflammatory Bowel Disease

Abstract: Limited health literacy is associated with lower ratings of subjective health and depression in IBD and more symptoms of active disease in patients with Crohn's disease.

Cited by 43 publications

References 61 publications

Impact of Limited Health Literacy on Patient‐Reported Outcomes in Systemic Lupus Erythematosus

Impact of Limited Health Literacy on Patient‐Reported Outcomes in Systemic Lupus Erythematosus

Health literacy: Impact on quality of life in head and neck cancer survivors

Health Literacy Assessments May Be Inconsistently Conducted in IBD Patients

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