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Author Notes:
Candace D. McNaughton, MD, MPH, Department of Emergency Medicine, 703 Oxford House, 1313 21st Avenue South, Nashville, TN, USA, Phone: 615-936-0087, Fax: 615-936-1316, candace.mcnaughton@vanderbilt.edu.
Authors have no relevant conflicts of interest to declare.
Subjects:
Research Funding:
This study was supported by a grant from the American Heart Association.
Dr. McNaughtons time was supported by the Vanderbilt Emergency Medicine Research Training (VEMRT) Program (HL 1K12HL109019).
Keywords:
- Science & Technology
- Social Sciences
- Life Sciences & Biomedicine
- Public, Environmental & Occupational Health
- Social Sciences, Interdisciplinary
- Social Sciences - Other Topics
- Hypertension control
- Literacy
- Medication adherence
- Blood pressure control
- LOW HEALTH LITERACY
- MEDICATION ADHERENCE
- OUTCOMES
- IMPACT
- NUMERACY
- NONADHERENCE
- PREVALENCE
- PREDICTORS
- KNOWLEDGE
- AMERICAN
Low literacy is associated with uncontrolled blood pressure in primary care patients with hypertension and heart disease
Abstract:
Objectives: To evaluate the association between low literacy and uncontrolled blood pressure (BP) and their associations with medication adherence.
Methods: Cross-sectional study of 423 urban, primary care patients with hypertension and coronary disease. The relationship between low literacy (Rapid Estimate of Adult Literacy in Medicine. ≤. 44) and uncontrolled BP (≥140/90. mmHg, ≥130/80. mmHg for patients with diabetes) was evaluated by crude and adjusted logistic regression. Relationships with self-reported adherence and refill adherence were explored using adjusted linear and logistic regression.
Results: Overall, 192 (45%) subjects had low literacy and 227 (52.9%) had uncontrolled BP. Adjusting for age, gender, race, employment, education, mental status, and self-reported adherence, low literacy was associated with uncontrolled BP (OR 1.75, 95% CI 1.06-2.87). Lower self-reported adherence was associated with uncontrolled BP; the relationship between refill adherence and uncontrolled BP was not statistically significant.
Conclusion: Low literacy is independently associated with uncontrolled BP. Practice implications: Awareness of the relationships among patient literacy, BP control, and medication adherence may guide healthcare providers as they communicate with patients.
Copyright information:
© 2014 Elsevier Ireland Ltd.
This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).
