Health literacy and decision making styles for complex antithrombotic therapy among older multimorbid adults

PATIENT EDUCATION AND COUNSELING

卷:85

Article

Naik, Aanand D.^1,2  Street, Richard L., Jr.^1,3  Castillo, Diana¹  Abraham, Neena S.^1,2 

[1] Michael E DeBakey VA Med Ctr, Houston HSR&D Ctr Excellence, Houston, TX USA

[2] Baylor Coll Med, Dept Med, Houston, TX 77030 USA

[3] Texas A&M Univ, Dept Commun, College Stn, TX USA

关键词: Aging;    Drugs;    Prevention;    Literacy;    Doctor-patient relationship;   

DOI  :  10.1016/j.pec.2010.12.015

来源: Elsevier

【 摘 要 】

Objectives: To evaluate the effect of functional health literacy (FHL) on preferences for decision-making; and among those initially preferring a passive decision-making role, to explore how preferences change if their physician actively encourages their involvement. Methods: Consecutive older adults with cardiovascular disease receiving complex antithrombotic therapy completed a comprehensive assessment including measures of FHL and preferences for shared decision making. Results: Half of all participants had inadequate or marginal FHL. Those with inadequate FHL were more likely (P = 0.01) to prefer passive rather than active decision making styles even after controlling for age, education, and numeracy. However, 40% of patients preferring passive styles had adequate FHL and these patients were significantly more likely to change their preference to more active styles (odds ratio = 7.17, P < .01) if their physician was more supportive or encouraged participation. Conclusions: Screening FHL can provide insight into patients' preferences for active participation in decision making. Clinicians' encouragement of participation can increase engagement by patients with adequate FHL. Practice implications: We propose an algorithm for screening FHL and preferences for participating in decisions about complex medication regimens. Published by Elsevier Ireland Ltd.

【 授权许可】

Free