Relation between health literacy, self-care and adherence to treatment with oral anticoagulants in adults: a narrative systematic review

Abstract

BackgroundOral anticoagulants (OAC) are widely used in patients with cardiovascular diseases. However, for optimal OAC self-care patients must have skills, among which health literacy (HL) is highlighted. We aimed to describe the relation between HL and self-care in cardiovascular patients on OAC treatment.MethodsElectronic searches were carried out in the PubMed, Scopus, Embase, CINAHL, Web of Science, Cochrane Library, SciELO, IME-Biomedicina, CUIDEN Plus and LILACS databases, limited to Spanish and English language and between January 2000–December 2016. Papers reported on adults older than 18 years, taking OAC by themselves for at least three months. PRISMA guidelines were used for paper selection.ResultsWe identified 142 articles and finally included 10; almost all of them about warfarin. Our results suggest that in patients taking OAC treatments there is a positive relationship between HL and the level of knowledge. In addition, a small percentage of participants on the selected papers recognized the side effects and complications associated with OAC treatment. Lower HL level was associated with greater knowledge deficits and less adherence to treatment.ConclusionThere is a paucity of research evaluating the effect of HL on diverse aspects of OAC treatments. There is a need to expand the evidence base regarding appropriate HL screening tools, determinants of adequate knowledge and optimal behaviours related to OAC self-management.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6070-9) contains supplementary material, which is available to authorized users.

Relationship between Determinants of Health, Equity, and Dimensions of Health Literacy in Patients with Cardiovascular Disease

“…HL, in addition to being related to the determinants described above, may be associated with hyperfrequentation of health services and a greater rate of adverse events. This fact is described by different studies in patients with cardiovascular pathology, which associate lower HL scores with higher rates of rehospitalization [42] and increased risk of mortality [42][43][44]. For this reason, we are currently studying this possibility in our study population, since we consider it necessary to know the relationship between HL and certain therapeutic and clinical indicators in patients with cardiovascular pathology.…”

IC-Health Project: Development of MOOCs to Promote Digital Health Literacy: First Results and Future Challenges

“…The improvement of DHL and HL represents a challenge for both society and health services because people with low levels of HL may have difficulties in interpreting indications in written format, such as prescriptions or hospital discharge reports [1,2]. In addition, they have worse health outcomes compared to those with an adequate level of HL, such as: a higher risk of hospitalizations, a higher ratio of admissions to emergency departments, a lower adjusted quality of life score in patients with chronic diseases and less therapeutic adherence [8][9][10].…”

“…3. Health and the Internet: in this case, the 8 items of the eHeaLS scale [23] were used (questions [10][11][12][13][14][15][16][17]. This scale was complemented by additional ad hoc questions aimed at investigating the participants' frequency, motivations, feelings and habits in using the Internet for health-related purposes.…”

The use of visual risk communication and its significance for risk understanding and health literacy in out-clinic settings – a literature review

“…Low health literacy (the ability to understand, obtain and apply healthcare information in order to make appropriate health decisions and follow instructions for treatment) is generally associated with poor health (5). If the patient fails to initiate treatment as agreed with the general practitioner (GP) or does not comply with the treatment plan, it may cause health deterioration or reduced quality of life for the individual and increased healthcare expenses for the society (6).…”