Assessment of Oral Chemotherapy Nonadherence in Chronic Myeloid Leukemia Patients Using Brief Measures in Community Cancer Clinics: A Pilot Study

The purpose of this pilot study was to assess Chronic Myeloid Leukemia (CML) patients’ adherence to, beliefs about, and barriers to oral anticancer agents (OAC) using brief self-report measures in community-based cancer clinics. Patients completed a structured interview including a health literacy assessment, a Brief Medication Questionnaire, two single-item self-report adherence questions, and the Medications Adherence Reasons Scale. Of the 86 participants, 88.4% were white; 55.8% male; mean age, 58.7 years; and 22.1% had limited health literacy. Nonadherence (missing at least one dose in the last week) was reported by 18.6% of participants and associated (p < 0.003) with less-than-excellent perceived ability to take CML medications (16.3%). Black participants reported more difficulty taking CML medications than white participants (28.6% vs. 8.3%, p = 0.053). Among all participants, 43.0% reported their CML medicine was ineffective and 24.4% that taking CML pills was somewhat to very hard. The most common reasons for missing a dose were simply missed it (24.4%) and side effects (18.6%). Most patients perceived their ability to take CML medication was good to excellent, yet nearly one in five reported missing at least one dose in the last week. Brief, no-cost self-report assessments to screen CML patients’ OAC adherence, barriers, and beliefs could facilitate counseling in busy community cancer clinics.

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Health literacy assessment of Vidzeme statistical region

10.22616/esrd.2021.55.047 ◽

2021 ◽

Author(s):

Baiba Kondrica ◽

◽

Ilze Ivanova ◽

Tamara Grizane ◽

◽

...

Keyword(s):

Health Literacy ◽

Strong Positive Correlation ◽

Literacy Assessment ◽

Limited Health Literacy ◽

Telephone Interviews ◽

Confirmatory Factor ◽

Literacy Survey ◽

Impacting Factors ◽

European Health ◽

Limited Health

Data on Health Literacy in the population of Latvia is limited. The aim of the study was to determine the Health Literacy impacting factors of inhabitants of Vidzeme Statistical region in Latvia (LV008). Respondent survey (n = 383), using a paper-and-pencil self-administered approach and telephone interviews, was conducted based the European Health Literacy Survey Questionnaire (HLS-EU-Q47). In order to ensure internal consistency and reliability, the authors used Cronbach’s α test (α = 0.965). The confirmatory factor analysis (CFA) allowed to determine that factor results differentiate between genders and there is a strong positive correlation (r = 0.945), that impacts results. Factors Access, Appraise and Apply explained each 30 % of the variance, and factors Understand explained 31 %. HL index division by gender indicated that 47.4 % of female respondents and 46.6 % of male respondents have “limited health literacy” (“inadequate” + “problematic”). The largest age group among respondents are 18-39-year old where there is lower level of education and lower income. However, cases have been observed when respondents even with higher education have “limited health literacy,” which indicates towards a need for further HL research in Latvia, because compared to HL of other member states, LV008 HL index is by 38.9 % larger than the EU average (47.6 %).

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An Innovative Health Literacy Approach Designed to Improve Patient Understanding of Medication Labeling

Therapeutic Innovation & Regulatory Science ◽

10.1007/s43441-021-00325-5 ◽

2021 ◽

Author(s):

Kara L. Jacobson ◽

Juliette Faughnan ◽

Laurie Myers ◽

Amy Dubost ◽

Lisa Courtade ◽

...

Keyword(s):

Health Literacy ◽

Focus Group ◽

Package Insert ◽

Assessment Tools ◽

Evidence Based ◽

Literacy Assessment ◽

Limited Health Literacy ◽

Patient Medication ◽

Content Development ◽

Limited Health

Abstract Objective Limited health literacy negatively impacts understanding of medication-related information. We describe an innovative methodology designed to optimize user understanding of patient medication labeling through the systematic application of evidence-based health literacy principles, using the Patient Package Insert (PPI) for bezlotoxumab (ZINPLAVA™, Merck & Co., Inc., Kenilworth, NJ, USA) as an example. Methods We used a mixed-model, iterative approach consisting of three phases: (1) content development; (2) focus group testing; and (3) comprehension testing. Content development was based on evidence-based health literacy principles and conducted through a collaborative partnership between industry and academia professionals. The PPI was then tested in four focus groups, two in Atlanta and two in Chicago, with an emphasis on collecting feedback from respondents with limited health literacy, evaluated using the Newest Vital Sign (NVS) health literacy assessment tool. Subsequent comprehension testing included patients with C. diff, caregivers, and general population members, with a pre-defined target sample of 25% with limited health literacy identified through two health literacy assessment tools: the Single Item Literacy Screener and the NVS. Results Content development of the bezlotoxumab PPI occurred in May 2015. In June 2015, focus group respondents (n = 34) provided generally favorable feedback, with insights revolving around organization and usability; language and comprehension; and volume of information. Comprehension testing of the revised PPI resulted in average comprehension scores of 96% for the overall population (n = 59), 90% for individuals presenting with limited health literacy (n = 14), and 97% for those with adequate health literacy (n = 45). This PPI development approach was similarly effective for subsequent products across diverse therapeutic areas, with comprehension scores ≥ 86% for all participants (n = 1197). Conclusion This methodology represents a significant advancement for the development of understandable patient medication labeling, especially for people with limited health literacy.

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A Computerized Asthma Screening Program For Patients With Limited Health Literacy: A Pilot Study

10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a1464 ◽

2010 ◽

Author(s):

Perla A. Vargas ◽

Elias Robles ◽

Peggy Radford ◽

Judith Harris

Keyword(s):

Health Literacy ◽

Pilot Study ◽

Screening Program ◽

Limited Health Literacy ◽

Limited Health

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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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Can Screening Items Identify Surgery Patients at Risk of Limited Health Literacy?

Journal of Surgical Research ◽

10.1016/j.jss.2007.01.029 ◽

2007 ◽

Vol 140 (2) ◽

pp. 208-213 ◽

Cited By ~ 75

Author(s):

Lorraine S. Wallace ◽

David C. Cassada ◽

Edwin S. Rogers ◽

Michael B. Freeman ◽

Oscar H. Grandas ◽

...

Keyword(s):

At Risk ◽

Health Literacy ◽

Limited Health Literacy ◽

Patients At Risk ◽

Limited Health

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AB0300 LUPUS DISEASE ACTIVITY CORRELATES WITH QUALITY OF LIFE BUT NOT WITH HEALTH LITERACY STATUS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.581 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1176.2-1176

Author(s):

E. Eraslan ◽

R. Bilici Salman ◽

H. Satiş ◽

A. Avanoglu Guler ◽

H. Karadeniz ◽

...

Keyword(s):

Quality Of Life ◽

Health Literacy ◽

Disease Activity ◽

Lupus Erythematosus ◽

Patient Reported Outcome ◽

The Body ◽

Limited Health Literacy ◽

Patient Reported ◽

Limited Health

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology that can affect any organ of the body. SLE is associated with adverse effects on both health and non-health-related quality of life (HRQOL and non-HRQOL). Lupus PRO is a patient reported outcome measure that has been validated in many languages. It has 44 items that cover both HRQOL and non-HRQOL (1). Health literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions. Multiple studies indicate that people with limited health literacy have worse health status and higher rates of hospitalization (2).Objectives:We aimed to evaluate the relationship between the LLDAS (Lupus Low Disease Activity State) criteria and the Lupus PRO test, as well as the health literacy status of lupus patients.Methods:83 SLE patients (94% women) were included in the study. We performed Lupus PRO and the European Health Literacy Survey tests during the routine follow-up visits of lupus patients to our rheumatology outpatient clinic and admissions to rheumatology inpatient clinic. Available clinical data on medical records were obtained, physician global assessments (PGA) were recorded by the attending physician.Results:LLDAS criteria strongly and inversely correlated with the total score, as well as the mood subunit of the Lupus PRO. Similarly, it also significantly inversely correlated with the body appearence and goals subunits. Health literacy status of the patients did not correlate with their LLDAS scores, ie their disease activities.Conclusion:Our results suggest that lupus disease activity, assessed by LLDAS criteria, significantly correlates with measures of quality of life, spesicifically Lupus PRO test, but not with health literacy status. Further studies are needed to evaluate if health literacy is related with damage, hospitalization or mortality associated with lupus.References:[1]Jolly M, Pickard AS, Block JA, Kumar RB, Mikolaitis RA, Wilke CT, et al., editors. Disease-specific patient reported outcome tools for systemic lupus erythematosus. Seminars in arthritis and rheumatism; 2012: Elsevier.[2]Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR. The prevalence of limited health literacy. Journal of general internal medicine. 2005;20(2):175-84.Disclosure of Interests:None declared

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Adherence to Tyrosine Kinase Inhibitor Therapy in Patients with Chronic Myeloid Leukemia: Meta-Analyses of Prevalence Rates By Measurement Method

Blood ◽

10.1182/blood.v128.22.3610.3610 ◽

2016 ◽

Vol 128 (22) ◽

pp. 3610-3610 ◽

Cited By ~ 4

Author(s):

Ziyad Alrabiah ◽

Abdulaziz Alhossan ◽

Seongseok Yun ◽

Karen MacDonald ◽

Ivo Abraham

Keyword(s):

Chronic Myeloid Leukemia ◽

Tyrosine Kinase ◽

Myeloid Leukemia ◽

Kinase Inhibitor ◽

Meta Analysis ◽

Medication Possession Ratio ◽

Structured Interview ◽

Proportion Of Days Covered ◽

Equity Ownership ◽

Meta Analyses

Abstract Introduction: First- (imatinib) and second-generation (dasatinib, nilotinib) tyrosine kinase inhibitors are the standard of care in the management of chronic myeloid leukemia. Despite their high efficacy and the convenience of oral administration, studies have reported variation in patient medication behavior with non-adherence rates varying from low to moderate based on definition and measurement method. We conducted study-level meta-analyses stratified by measurement method to quantify adherence prevalence rates in chronic myeloid leukemia patients as reported in non-controlled "real-life" studies. Methods: We searched PubMed, Embase, and Cochrane Library for non-controlled studies reporting adherence or non-adherence rates to tyrosine kinase inhibitor treatment in chronic myeloid leukemia patients across various methods of measurement. For retained studies, adherence rates and 95% confidence interval (95% CI) were extracted or calculated; and grouped by method of measurement. Random-effects meta-analyses were performed to account for estimated (Q, I2, tau2) within and between study heterogeneity, and associated forest plots were generated. Analyses were done using Comprehensive Meta-Analysis V.3. Results: From 649 publications yielded by the search, 40 articles and abstracts were retained. Measurement methods included structured interview, medical/pharmacy chart review, medication possession ratio, proportion of days covered, electronic monitoring, and self-report. Electronic monitoring and self-report were used in one study each and thus excluded from meta-analysis. Table 1 summarizes, by the remaining four methods, the number of studies and patients included in each meta-analysis, the estimated adherence event rates with 95%CI, and heterogeneity indices. In random-effects analyses, adherence rate estimates as measured by each method ranged (in descending order) from 0.75 (95%CI=0.66-0.82) for structured interview, 0.68 (95%CI=0.54-0.79) for medical/pharmacy chart review, 0.57 (95%CI=0.47-0.67) for medication possession ratio, to 0.56 (95%CI=0.36-0.74) for proportion of days covered. All four analyses showed significant heterogeneity. Conclusion: Our meta-analyses using clinical data (structured interview; medical/pharmacy chart review) indicate that, while the majority of chronic myeloid leukemia patients are adherent to their tyrosine kinase inhibitor regimens, between 1/3rd and 1/4th of them are not. Indirect methods using prescription claims data (medication possession ratio; proportion of days covered) yielded lower adherence rates, though caution about such indirect results is warranted. Considering evidence linking adherence to impaired cytogenetic (Noens et al, Blood 2009) and molecular response (Marin et al, J Clin Oncol 2010), clinicians should integrate adherence assessment and enhancement into routine clinical practice. Table 1 Table 1. Disclosures MacDonald: Matrix45: Employment, Equity Ownership; Ex Ante International: Equity Ownership. Abraham:Matrix45: Equity Ownership; Belgamis: Equity Ownership; Ex Ante International: Equity Ownership.

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