Abstract
PurposeThe levels of health literacy in patients with long-term conditions (LTCs) are critical for better disease management and quality of life (QoL). However, the impact of health literacy on QoL in older adults with LTCs is unclear. This study examined the association between health literacy and domains of QoL in older people with LTCs, investigating key socio-demographic and clinical variables, as confounders.MethodsA prospective cohort study was conducted on older adults (n = 4278; aged 65 years and over) with at least one LTC, registered in general practices in Salford, UK. Participants completed measures of health literacy, QoL, multi-morbidity, depression, social support, and socio-demographic characteristics. Multivariate linear regressions were performed to examine the effects of health literacy on four QoL domains at baseline, and then changes in QoL over 12 months.ResultsAt baseline, poor health literacy was associated with lower scores in all four QoL domains (physical, psychological, social relationships and environment), after adjusting for the effects of multi-morbidity, depression, social support and socio-demographic factors. At 12-month follow-up, low health literacy significantly predicted declines in the physical, psychological and environment domains of QoL, but not in social relationships QoL.ConclusionsThis is the largest, most complete assessment of the effects of health literacy on QoL in older adults with LTCs. Low health literacy is an independent indicator of poor QoL older patients with LTCs. Interventions to improve health literacy in older people with LTCs are encouraged by these findings.
Highlights
The management of long-term conditions (LTCs) is a key challenge facing healthcare systems worldwide as the number of people experiencing one or more LTCs rises [1,2,3]
A key focus of the management of LTCs is to maintain and improve the quality of life (QoL) of patients [5, 6] which is linked with lower rates of unplanned healthcare utilization and costs [5, 7, 8]
The main aim of this study was to examine the effects of health literacy on different domains of QoL, in a large sample of older adults with LTCs, and to do this with cross-sectional and prospective data
Summary
The management of long-term conditions (LTCs) is a key challenge facing healthcare systems worldwide as the number of people experiencing one or more LTCs rises [1,2,3]. Care costs of LTCs are high, and are steep for patients and for their families and healthcare systems [4, 5] Given this resource burden, a key focus of the management of LTCs is to maintain and improve the quality of life (QoL) of patients [5, 6] which is linked with lower rates of unplanned healthcare utilization and costs [5, 7, 8]. Certain patient groups who have socio-economic deprivation, poor education, limited health literacy, symptoms of depression and little social support are more likely to receive sub-optimal quality of care for these conditions, and to report poor QoL [12,13,14]
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