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Health Literacy

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Limited health literacy is a barrier to patients taking the correct prescribed medications

Patients with low health literacy typically have difficulty understanding the names of prescription medications, their indications for use, and dosing instructions. This confusion can lead to missed doses or wrongly timed doses. Low literacy can also lead to a disconnect between what medications the patient and doctor think the patient is taking, suggests a new study. When doctors and patients agree on what medications the patient is taking (medication reconciliation), there is less likelihood of medication errors or adverse effects. However, the study found that low health literacy among adults with hypertension was linked to a greater number of unreconciled medications.

Northwestern University researchers, led by Stephen D. Persell, M.D., M.P.H., administered the short-form Test of Functional Health Literacy to 119 adults with hypertension from 3 community health centers. They also asked them about the medications they took for their high blood pressure. Nearly one-third (31 percent) of the adults had inadequate health literacy. After adjusting for age and income, less literate patients were nearly three times less able than their more literate counterparts to name any of their antihypertensive medications.

Agreement between patient-reported medications and those documented in their medical record was low: 64.9 percent of patients with inadequate and 37.8 percent with adequate literacy had no medications common to both lists. Being unable to state which medications they are using by name (and also by dose) could be important, particularly when patients interact with providers other than their usual source of outpatient care (for example, hospitals or emergency departments). The study was supported in part by the Agency for healthcare Research and Quality (HS15647).

See "Limited health literacy is a barrier to medication reconciliation in ambulatory care," by Dr. Persell, Chandra Y. Osborn, Ph.D., Robert Richard, M.D., and others, in the November 2007 Journal of General Internal Medicine 22(11), pp. 1523-1526.

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