Abstract
BackgroundAssessment health literacy in people with cardiovascular health problems would facilitate the development of appropriate health strategies for the care and reduction of complications associated with oral anticoagulation therapy. Aim: To evaluate the relationship between health literacy and health and treatment outcomes (concordance with oral anticoagulants, Normalized Ratio control and occurrence of complications) in patients with cardiovascular pathology.MethodsObservational, analytic and cross-sectional study carried out on 252 patients with cardiovascular pathology (atrial fibrillation, flutter or valve prosthesis), aged 50–85 years, accessing primary care services in Valencia (Spain) in 2018–2019. Variables referring to anticoagulant treatment with vitamin K antagonists (years of treatment, adequate control, polypharmacy and occurrence of complications, among others) and health literacy (Health Literacy Questionnaire) were analysed.ResultsAll dimensions of health literacy were significantly related to the level of education (p < 0.02), social class (p < 0.02), an adequate control of acenocoumarol (p < 0.001), frequentation of health services (p < 0.001), information by patients to health professionals about anticoagulant treatment (p < 0.03), emergency care visits (p < 0.001) and unscheduled hospital admissions (p < 0.001).ConclusionHealth literacy has a relevant influence on the adequate self-management of anticoagulation treatment and the frequency of complications. The different dimensions that comprise health literacy play an important role, but the “social health support” dimension seems to be essential for such optimal self-management.Trial registrationACC-ACE-2016-01. Registration date: December 2015.
Highlights
Assessment health literacy in people with cardiovascular health problems would facilitate the development of appropriate health strategies for the care and reduction of complications associated with oral anticoagulation therapy
We propose identifying the level of health literacy (HL) in the local population on anticoagulation treatment and exploring the relationship between HL and several health and clinical outcomes
Exclusion criteria included vision or hearing impairment that prevented the completion of the HL questionnaire, illiteracy, discontinued treatment with vitamin K antagonists (VKAs), severe neurocognitive or mental health problems that prevented the patient from understanding their pathological conditions, and patients whose treatment with VKAs was administered by another person
Summary
Assessment health literacy in people with cardiovascular health problems would facilitate the development of appropriate health strategies for the care and reduction of complications associated with oral anticoagulation therapy. Therapeutic management of AF requires modification of cardiovascular risk factors and use of drugs [1, 2] such as oral anticoagulants (OAC). The legal requirement for a visa and the high financial cost of DOACs prescribing make it difficult to obtain widespread access for patients [5]. For such reasons, VKAs continue to be the most frequently used OAC in Spain, despite the need for routine blood tests and an exquisite clinical control [6]. It is vital that patients demonstrate adequate self-care, along with treatment concordance and sufficient knowledge to avoid or mitigate adverse effects, to maintain the effectiveness of this treatment
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