Abstract
BackgroundAppropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life.ObjectivesTo assess the relationship between health literacy and health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), and to investigate the role of sociodemographic and clinical variables as possible confounders.MethodsCross-sectional study of patients with IHD recruited from a stratified sample of general practices in two Australian states (Queensland and South Australia) between 2007 and 2009. Health literacy was measured using a validated questionnaire and classified as inadequate, marginal, or adequate. Physical and mental components of HRQoL were assessed using the Medical Outcomes Study Short Form (SF12) questionnaire. Analyses were adjusted for confounders (sociodemographic variables, clinical history of IHD, number of CVD comorbidities, and CVD risk factors) using multiple linear regression.ResultsA total sample of 587 patients with IHD (mean age 72.0±8.4 years) was evaluated: 76.8% males, 84.2% retired or pensioner, and 51.4% with up to secondary educational level. Health literacy showed a mean of 39.6±6.7 points, with 14.3% (95%CI 11.8–17.3) classified as inadequate. Scores of the physical component of HRQoL were 39.6 (95%CI 37.1–42.1), 42.1 (95%CI 40.8–43.3) and 44.8 (95%CI 43.3–46.2) for inadequate, marginal, and adequate health literacy, respectively (p-value for trend = 0.001). This association persisted after adjustment for confounders. Health literacy was not associated with the mental component of HRQoL (p-value = 0.482). Advanced age, lower educational level, disadvantaged socioeconomic position, and a larger number of CVD comorbidities adversely affected both, health literacy and HRQoL.ConclusionInadequate health literacy is a contributing factor to poor physical functioning in patients with IHD. Increasing health literacy may improve HRQoL and reduce the impact of IHD among patients with this chronic CVD.
Highlights
Ischaemic heart disease (IHD) is a common cardiovascular disease (CVD), and a leading cause of global morbidity and mortality [1]
Health literacy was not associated with the mental component of health-related quality of life (HRQoL) (p-value = 0.482)
The positive effect of health literacy on health outcomes has been widely discussed in the literature [8, 9, 11, 14, 15] but, to our knowledge, this is the first study to investigate its influence on HRQoL in patients with IHD
Summary
Ischaemic heart disease (IHD) is a common cardiovascular disease (CVD), and a leading cause of global morbidity and mortality [1]. Frequent complications and hospitalisations related to this condition are expected to increase total health expenditures from 9.4% in 2002–03 to 10.8% in the 30 years [3]. Given this resource burden, the contemporary management of IHD and other CVD should focus on decreasing morbidity and mortality, and on improving quality of life (QoL) [4,5,6]. Appropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can benefit their quality of life
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