Relationship Between Health Literacy and Adherence to Treatment in Cardiac Patients

Document Type : Original Article

Authors

1 Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

2 Department of Anesthesiology, Hazrat Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, IR Iran.

3 Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

4 Gastrointestinal and Liver Disease Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IR Iran.

5 Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

Abstract

Background: Today, health literacy is introduced as a global issue and debate, and low health literacy appears to be related to nonadherence to healthy lifestyle behaviors and health inequalities. Therefore, the aim of this study was to investigate the health status of patients with cardiovascular disease and its relationship with the patients’ adherence status to their drug therapy.
Methods: The present study was a descriptive correlational study. The research population comprised the patients referred to our clinics. Four hundred participants were selected based on the inclusion and exclusion criteria from the research population. The sampling method was simple random sampling. The instrument consisted of 2 parts: the first part evaluated demographic information and the second part was based on the combination of 2 standard instruments of cardiovascular literacy and adherence to treatment, which were used after being modified and reassessed in terms of validity and reliability. The obtained information was analyzed with the SPSS software, version 19. Descriptive and analytical statistics were used.
Results: The Spearman test indicated general health literacy had a significant relationship with treatment (r = 0.31, P < 0.001). This correlation was also observed in relation to the subscales of perception of health (r = 0.27) and health behavior by adherence to treatment (r = 0.29,
P < 0.001). If the participants received information through their physicians, they showed a significant relationship between health literacy (in all subscales) and adherence to treatment (P < 0.001).
Conclusions: The results showed a high correlation between health literacy and adherence to treatment. Therefore, considering the importance of cardiovascular diseases, as well as the importance of health literacy and its relevance to adherence to treatment, we suggest that the television sets located in the clinics of the center broadcast educational videos during the waiting period for the clients.

Keywords


1. Members WG, Benjamin EJ, Blaha MJ, Chiuve
SE, Cushman M, Das SR, et al. Heart disease
and stroke statistics—2017 update: a report from
the American Heart Association. Circulation.
2017;135(10):e146.
2. Network CC. The Ontario cardiac rehabilitation
pilot project: Report and recommendations.
Toronto, ON: Cardiac Care Network. 2002.
3. de Melo Ghisi GL, da Silva Chaves GS, Britto
RR, Oh P. Health literacy and coronary artery
disease: A systematic review. Patient education
and counseling. 2018;101(2):177-84
4. Aldcroft SA, Taylor NF, Blackstock FC,
O'Halloran PD. Psychoeducational rehabilitation
for health behavior change in coronary artery
disease: a systematic review of controlled trials.
Journal of cardiopulmonary rehabilitation and
prevention. 2011;1(5):273-81
5. Berkman ND, Davis TC, McCormack L. Health
literacy: what is it? Journal of health
communication. 2010;15(S2):9-19.
6. Santos RD. Better health literacy can make the
difference when control of risk factors for
cardiovascular disease and quality of life are
concerned. SAGE Publications Sage UK:
London, England; 2017.
7. Aaby A, Friis K, Christensen B, Rowlands G,
Maindal HT. Health literacy is associated with
health behaviour and self-reported health: A
large population-based study in individuals with
cardiovascular disease. European journal of
preventive cardiology. 2017;24(17):1880-8.
8. Berkman ND, Sheridan SL, Donahue KE,
Halpern DJ, Crotty K. Low health literacy and
health outcomes: an updated systematic review.
Annals of internal medicine. 2011;155(2):97-
107.


9. Carollo S. Low health literacy in older women:
The influence of patient–clinician relationships.
Geriatric Nursing. 2015;36(2):S38-S42.
10. Izadirad H, Zareban I. The relationship of health
literacy with health status, preventive behaviors
and health services utilization in Baluchistan,
Iran. Journal of Education and Community
Health. 2015;2(3):43-50.
11. Rolls CA, Obamiro KO, Chalmers L, Bereznicki
LR. The relationship between knowledge, health
literacy, and adherence among patients taking
oral anticoagulants for stroke
thromboprophylaxis in atrial fibrillation.
Cardiovascular therapeutics. 2017;35(6):e12304.
12. Lee Y-M, Yu HY, You M-A, Son Y-J. Impact
of health literacy on medication adherence in
older people with chronic diseases. Collegian.
2017;24(1):11-8.
13. Kooshyar H, Shoorvazi M, Dalir Z, Hosseini M.
Health literacy and its relationship with medical
adherence and health-related quality of life in
diabetic community-residing elderly. Journal of
Mazandaran University of Medical Sciences.
2014;23(1):134-43.
14. Montazeri A, Tavousi M, Rakhshani F, Azin
SA, Jahangiri K, Ebadi M, et al. Health Literacy
for Iranian Adults (HELIA): development and
psychometric properties. 2014.
15. Plakas S, Mastrogiannis D, Mantzorou M,
Adamakidou T, Fouka G, Bouziou A, et al.
Validation of the 8-item Morisky Medication
Adherence Scale in chronically ill ambulatory
patients in rural Greece. Open Journal of
Nursing. 2016;6(03):158.
16. Javadzade SH, Sharifirad G, Radjati F,
Mostafavi F, Reisi M, Hasanzade A.
Relationship between health literacy, health
status, and healthy behaviors among older adults
in Isfahan, Iran. J Educ Health Promot.
2012;1:31. pp: 1-7.
17. Walker J, Pepa C, Gerard PS. Assessing the
health literacy levels ofpatients using selected
hospital services. Clinical Nurse Specialist.
2010;24(1):31-7.
18. Arozullah AM, Lee SYD, Khan T, Kurup S,
Ryan J, Bonner M, et al. The roles of low
literacy and social support in predicting the
preventability of hospital admission .Journal of
general internal medicine. 2006;21(2):140-5.
19. Baker DW, Gazmararian JA, Williams MV,
Scott T, Parker RM, Green D, et al. Health
literacy and use of outpatient physician services
by Medicare managed care enrollees. Journal of
General Internal Medicine. 2004;19(3):215-20.
20. Cho YI, Lee S-YD, Arozullah AM, Crittenden
KS. Effects of health literacy on health status
and health service utilization amongst the
elderly. Social science & medicine.
2008;66(8):1809-16.
21. Csete J, Kamarulzaman A ,Kazatchkine M,
Altice F, Balicki M, Buxton J, et al. Public
health and international drug policy. The Lancet.
2016;387(10026):1427-80.
22. Barford A, Dorling D, Smith GD, Shaw M. Life
expectancy: women now on top everywhere:
during 2006, even in the poorest countries,
women can expect to outlive men. BMJ: British
Medical Journal. 2006;332(7545):808.
23. Hardie NA, Kyanko K, Busch S, LoSasso AT,
Levin RA. Health literacy and health care
spending and utilization in a consumer-driven
health plan. Journal ofHealth Communication.
2011;16(sup3):308-21.
24. Scott TL, Gazmararian JA, Williams MV, Baker
DW. Health literacy and preventive health care
use among Medicare enrollees in a managed
care organization. Medical care.
2002;40(5):395-404.
25. Andrus MR, RothMT. Health literacy: a review.
Pharmacotherapy: The Journal of Human
Pharmacology and Drug Therapy.
2002;22(3):282-302.
26. Kvedar J, Coye MJ, Everett W. Connected
health: a review of technologies and strategies to
improve patient care with telemedicine and
telehealth. Health Affairs. 2014;33(2):194-9.
27. Headley AJ, Harrigan J. Using the pregnancy
perception of risk questionnaire to assess health
care literacy gaps in maternal perception of
prenatal risk. Journal of the national medical
association. 2009;101(10):1041-5.