Primary Care Experiences of Emergency Department Patients With Limited Health Literacy

Limited health literacy (HL) is linked to many negative health outcomes, including poor self-management of chronic diseases and medication adherence among patients. There are a lack of data regarding HL in the elderly population in Malaysia. This study aimed to determine the prevalence of limited HL levels and its associated factors among elderly patients in an urban academic primary care clinic in Selangor, Malaysia. A cross-sectional study was conducted among 413 elderly patients (≥60 years old) who attended this academic primary care clinic between January 2020 and January 2021. Sociodemographic data, clinical characteristics, and health literacy scores were collected. Descriptive statistics (median with interquartile ranges (IQR), frequency, and percentages) and multiple logistic regression were utilized. The prevalence of limited HL in our population was 19.1% (95% CI: 15.3, 23). The middle-old (70–79 years) and very-old (≥80 years) age groups were more likely to have limited HL (aOR 4.05; 95% CI: 2.19, 7.52 and aOR 4.36; 95% CI: 1.02, 18.63, respectively). Those with at least secondary school education (aOR 0.06; 95% CI: 0.02, 0.24) and those who found medical information via the internet/television (aOR 0.21; 95% CI: 0.05, 0.93) had lower odds of having limited HL. In conclusion, having limited HL levels was not common among elderly patients in this primary care clinic. Further studies involving rural and larger primary care clinics in Malaysia are required to support these findings.

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277 Single-Item Health Literacy Screening Validation in Predicting Limited Health Literacy in an Academic Emergency Department

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2015.07.311 ◽

2015 ◽

Vol 66 (4) ◽

pp. S100

Author(s):

A. Crum ◽

R. Horner ◽

Y. Waters ◽

H. Amin ◽

A. Ernst ◽

...

Keyword(s):

Emergency Department ◽

Health Literacy ◽

Single Item ◽

Limited Health Literacy ◽

Limited Health

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Evaluating the Association Between Single Item Literacy Screener and Health Outcomes in Patients With Lung Cancer

Innovation in Aging ◽

10.1093/geroni/igaa057.1387 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 429-430

Author(s):

Julie Nguyen ◽

Caitlyn McNaughton ◽

Jessica Sautter

Keyword(s):

Lung Cancer ◽

Emergency Department ◽

Health Literacy ◽

Older Patients ◽

Emergency Department Visits ◽

Healthcare Outcomes ◽

Single Item ◽

Limited Health Literacy ◽

Cancer Data ◽

Limited Health

Abstract Health literacy is becoming increasingly important in areas such as cancer care, where treatments are relatively difficult to navigate. This study aims to describe the how health literacy is associated with healthcare outcomes and health system usage among patients with lung cancer. Data include retrospective medical record data from 456 patients with lung cancer; half were age 70 and older. Patients were coded as having adequate or limited health literacy based on their response to their Single Item Literacy Screener (SILS). Data were collected from a 12 month period following diagnosis for each patient. One-third of patients had limited health literacy; this was significantly more common among adults age 70 and older. Patients with limited health literacy were more likely to have newly diagnosed lung cancers of stage 3B or higher (59.18% vs. 42.76%, p = 0.0011) compared to those with adequate health literacy. Patients with limited health literacy had higher median levels of depression based on the PHQ-9 questionnaire (4.0 vs. 3.0, p = 0.0082) and a higher median number of emergency department visits (1 vs. 0, p = 0.0156) and unplanned hospitalizations (1 vs. 0, p = 0.0044). Furthermore, patients with limited health literacy were more likely to have an emergency department visit or unplanned hospitalization sooner (p < 0.0001). These data illustrate a lower quality of life and a higher dependency on healthcare services for patients with limited health literacy. Assessment and interventions may be necessary to ensure access to quality healthcare.

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Malaysian Health Literacy: Scorecard Performance from a National Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115813 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5813

Author(s):

Norrafizah Jaafar ◽

Komathi Perialathan ◽

Manimaran Krishnan ◽

Nurashma Juatan ◽

Masitah Ahmad ◽

...

Keyword(s):

Health Literacy ◽

Nationwide Survey ◽

Population Based ◽

Average Score ◽

Future Health ◽

Limited Health Literacy ◽

Health Literacy Level ◽

Prevention And Health Promotion ◽

Literacy Level ◽

Limited Health

Health literacy is an indicator of a society’s ability to make better health judgements for themselves and the people around them. This study investigated the prevalence of health literacy among Malaysian adults and provided an overall picture of the society’s current health literacy status, which has not been previously assessed. The study also highlighted socio-demographic markers of communities with limited health literacy that may warrant future intervention. A population-based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized a two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above, drawn from the living quarter list, participated in the study. The health literacy score was divided into three levels; limited, sufficient, and excellent. Findings showed a majority of the Malaysian population had a sufficient health literacy level in all three domains—healthcare, diseases prevention and health promotion (49.1%, 44.2%, and 47.5%, respectively)—albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups were prevalent among respondents with older age (68%), lower education level (64.8%), and lower household income (49.5%). The overall health literacy status for Malaysia was categorized at a lower sufficiency level. Future health literacy improvements should focus on communities with a limited health literacy level to improve the overall score.

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Health literacy level in a various nephrology population from Québec: predialysis clinic, in-centre hemodialysis and home dialysis; a transversal monocentric observational study

BMC Nephrology ◽

10.1186/s12882-021-02464-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Annabel Boyer ◽

Yannick Begin ◽

Julie Dupont ◽

Mathieu Rousseau-Gagnon ◽

Nicolas Fernandez ◽

...

Keyword(s):

Health Literacy ◽

Observational Study ◽

Health Information ◽

Healthcare Providers ◽

Significant Proportion ◽

Good Health ◽

Sufficient Information ◽

Home Dialysis ◽

Limited Health Literacy ◽

Limited Health

Abstract Background Health literacy refers to the ability of individuals to gain access to, use, and understand health information and services in order to maintain a good health. It is especially important in nephrology due to the complexity of chronic kidney disease (CKD). The present study sought to define health literacy levels in patients followed in predialysis clinic, in-center dialysis (ICHD), peritoneal dialysis (PD) and home hemodialysis (HHD). Methods This transversal monocentric observational study analysed 363 patients between October 2016 and April 2017. The Brief Health Literacy Screen (BHLS) and the Health Literacy Questionnaire (HLQ) were used to measure health literacy. Multivariate linear regressions were used to compare the mean scores on the BHLS and HLQ, across the four groups. Results Patients on PD had a significantly higher BHLS’score than patients on ICHD (p = 0.04). HLQ’s scores differed across the groups: patients on HHD (p = 0.01) and PD (p = 0.002) were more likely to feel understood by their healthcare providers. Compared to ICHD, patients on HHD were more likely to have sufficient information to manage their health (p = 0.02), and patients in the predialysis clinic were more likely to report high abilities for health information appraisal (p < 0.001). Conclusion In a monocentric study, there is a significant proportion of CKD patients, especially in predialysis clinic and in-centre hemodialysis, with limited health literacy. Patients on home dialysis (HHD and PD) had a higher level of health literacy compared to the other groups.

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140. Symptoms and Situations Predispose Patients to Use Antibiotics Without Medical Advice

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.450 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S200-S200

Author(s):

Michael Hansen ◽

Barbara Trautner ◽

Roger Zoorob ◽

George Germanos ◽

Osvaldo Alquicira ◽

...

Keyword(s):

Primary Care ◽

Emergency Department ◽

Emergency Departments ◽

Primary Care Clinic ◽

Antibiotic Use ◽

Safety Net ◽

Care Clinic ◽

Primary Care Clinics ◽

Primary Care Patients ◽

Emergency Department Patients

Abstract Background Use of antibiotics without a prescription (non-prescription use) contributes to antimicrobial resistance. Non-prescription use includes obtaining and taking antibiotics without a prescription, taking another person’s antibiotics, or taking one’s own stored antibiotics. We conducted a quantitative survey focusing on the factors that impact patients’ decisions to use non-prescription antibiotics. Methods We surveyed patients visiting public safety net primary care clinics and private emergency departments in a racially/ethnically diverse urban area. Surveys were read aloud to patients in Spanish and English. Survey domains included patients’ perspectives on which syndromes require antibiotic treatment, their perceptions of health care, and their access to antibiotics without a prescription. Results We interviewed 190 patients, 122 from emergency departments (64%), and 68 from primary care clinics (36%). Overall, 44% reported non-prescription antibiotic use within the past 12 months. Non-prescription use was higher among primary care clinic patients (63%) than the emergency department patients (39%, p = 0.002). The majority felt that antibiotics would be needed for bronchitis (78%) while few felt antibiotics would be needed for diarrhea (30%) (Figure 1). The most common situation identified “in which respondents would consider taking antibiotics without contacting a healthcare provider was “got better by taking this antibiotic before” (Figure 2). Primary care patients were more likely to obtain antibiotics without prescription from another country than emergency department patients (27% vs. 13%, P=0.03). Also, primary care patients were more likely to report obstacles to seeking a doctor’s care, such as the inability to take time off from work or transportation difficulties, but these comparisons were not statistically significant. Figure 1. Patients’ agreement that antibiotics would be needed varied by symptom/syndrome. Figure 2. Situations that lead to non-prescription antibiotic use impacted the two clinical populations differently Conclusion Non-prescription antibiotic use is a widespread problem in the two very different healthcare systems we included in this study, although factors underlying this practice differ by patient population. Better understanding of the factors driving non-prescription antibiotic use is essential to designing patient-focused interventions to decrease this unsafe practice. Disclosures All Authors: No reported disclosures

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