Insufficient Healthcare Knowledge Major Impediment To Heart Disease Management

Insufficient Healthcare Knowledge Major Impediment To Heart Disease Management

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Highlights:
  • Inadequate health literacy in patients can prove to be a major roadblock in achieving the optimal patient outcome in heart diseases such as heart attack, stroke, and heart failure
  • Even among literate patients, inability to understand complex medical information, not being able to discuss their condition with doctors confidently or inability to calculate the correct dose of medicine, can affect healthcare outcomes adversely
  • Improving health literacy and making patients aware of their health condition and treatments is the responsibility of healthcare professionals
Improving health literacy of patients is the key to the improved patient outcome in heart diseases, according to a recent scientific statement that appears in the American Heart Association's journal Circulation.
Insufficient Healthcare Knowledge Major Impediment To Heart Disease Management

Instances of Problems Faced By Patients With Inadequate Healthcare Knowledge

A review of data gathered on the topic between 2004 and 2016 highlights difficulties faced by persons with limited health literacy
  • More than 50 percent of persons with low healthcare knowledge did not realize a blood pressure reading of 160/100 mmHg as abnormal and might need specific intervention. Thus insufficient health awareness makes it 1.8 to 2.7 times less likely that such patients would seek medical advice to bring their blood pressure under control
  • People with reduced health literacy are more likely to be dependent on nicotine and thrice as likely to relapse following a smoking cessation program
  • People with diabetes and low health literacy are more likely to develop diabetic complications such as retinopathy probably due to ignorance about fasting or postprandial blood sugar values or the importance of tests such as HbA1c.
  • Such patients are 1.7 times less likely to access online healthcare sites or portals to learn about their condition and understand the principles of treatment and ways to prevent complications
  • Parents with low health literacy are more likely to realize their overweight child as being normal weight, thereby avoiding putting corrective measures in place.
"The opportunities for communication failure by healthcare providers who treat people for heart disease risk factors, heart diseases and strokes are rampant," said Jared W. Magnani, M.D., M.Sc., chair of the writing group for the scientific statement and associate professor of medicine at the University of Pittsburgh School of Medicine in Pennsylvania.

Even educated patients find it difficult to navigate through the information provided in their test results or written information about disease conditions due to excessive use of medical terms or jargon.

"A patient with limited health literacy may not understand that a stress test described as "positive" is not a good result.," he continued. "Or we instruct patients to avoid sodium, when they may not know how to identify and quantify sodium intake or even how to interpret nutrition labels."

Persons Who Are More Likely To Be Health Illiterate

According to US statistics, limited health literacy is more likely to be encountered in the following populations -
  1. Racial and ethnic minorities
  2. Elderly patients
  3. Persons with limited English knowledge
  4. Less education
  5. Lower socioeconomic strata
  • Currently, only 12 percent of Americans are equipped with the necessary health literacy to benefit from the information boom available on the internet or successfully wade through the corridors of the healthcare system
  • Even persons with higher education can be overwhelmed by the unfamiliar medical terms and situations they may encounter, according to the published statement

How Healthcare Professionals Can Bridge The Gap Between Patients And Health Knowledge

The authors of the paper strongly advocate using "The Universal Precautions Toolkit", created by the federal Agency for Health Research and Quality

"The toolkit reminds us that health literacy is not a patient problem but is the result of the complexities of health care delivery. It calls on health care professionals to make changes that improve access to care for all patients," said Magnani.

Some of the measures suggested in the toolkit include
  • Avoiding using medical jargon and replace with simple terms understood by the lay person
  • Avoiding using medical diagrams in information booklets
  • Sharing information with the patient and answering their questions satisfactorily
  • Providing understandable forms, brochures or questionnaires
  • Provision of telephone access to patients to contact health professionals in case of difficulties
  • Asking patients to bring in all of their medications to the clinic to assess medication adherence and to explain risks and benefits to patients
  • Taking into consideration patient's culture, beliefs and customs in their care
  • Linking patients to specialist care and primary health care
"We employ specialized care for our patients and expect them to understand the reasons for it and make lifestyle changes and take medications daily, many of them for life. We owe it to our patients to ensure that they fully understand their conditions and treatments," Magnani said.

Conclusion

There have been several novel diagnostic and treatment advances in heart care during the last decade as well as the availability of novel cardiac devices and mobile health care initiatives, not to mention the increasing emphasis on shared decision making with regards to patient management. However, all these will have no value or likely not benefit the neediest patients as long as the issue of improving the health literacy of patients remains unaddressed.

References :
  1. Jared W. Magnani, Mahasin S. Mujahid, Herbert D. Aronow, Crystal W. Cené, Victoria Vaughan Dickson, Edward Havranek, Lewis B. Morgenstern, Michael K. Paasche-Orlow, Amy Pollak, Joshua Z. Willey, "Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association" Circulation (2018) (https://doi.org/10.1161/CIR.0000000000000579)


Source: Medindia

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