Published ahead of print on August 4, 2005, doi:10.1164/rccm.200409-1291OC
Am. J. Respir. Crit. Care Med., Volume 172, Number 8, October 2005, 980-986
A more recent version of this article appeared on October 15, 2005
Submitted on September 28, 2004
Accepted on August 2, 2005
Tailored Education May Reduce Health Literacy Disparities in Asthma Self-Management
Michael K Paasche-Orlow1*, Kristin A Riekert2, Andrew Bilderback2, Arjun Chanmugam3, Peter Hill3, Cynthia S Rand2, Fred L Brancati4, and Jerry A Krishnan4
1 Department of Medicine, Boston University School of Medicine, Boston, MA, USA,
2 Department of Medicine, Johns Hopkins University, Baltimore, MD, USA,
3 Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, USA,
4 Department of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
* To whom correspondence should be addressed. E-mail: mpo{at}bu.edu.
Rationale: Although inadequate health literacy has been associated with lower asthma medication knowledge and worse MDI technique, the relationship between health literacy and the capacity to learn asthma self-management skills is unknown.
Objectives: In this prospective cohort study of adults hospitalized for severe asthma exacerbations at 2 inner-city hospitals, we examined the relationship between inadequate health literacy and difficulties learning and retaining instructions about discharge medications and appropriate MDI technique.
Methods: At hospital discharge, participants received one-on-one, 30 minute, guideline-based, written and oral instruction about their asthma discharge regimen as well as appropriate MDI technique.
Measurements and Main Results: Seventy-three patients were enrolled. Inadequate health literacy was identified in 16 (22%) participants. Prior to instruction, inadequate health literacy was associated with lower asthma medication knowledge (5.2 versus 7.2, p<0.001) and worse MDI technique (p=3.2 versus 3.9, p=0.03). However, inadequate health literacy was not associated with difficulty learning (p=0.33) or retaining (p=0.35)instructions about the discharge regimen. Similarly, inadequate health literacy was not associated with difficulty learning (p=0.26) or retaining (p=0.97) appropriate MDI technique. Results were similar in multivariable models adjusted for demographic characteristics and asthma utilization.
Conclusions: These findings suggest that inadequate health literacy is a surmountable barrier to learning and remembering key asthma self-management skills.
Key words: Asthma, Health Literacy, Education
This article has been cited by other articles:
|
|
|
|
 
D. A. DeWalt and A. Hink
Health Literacy and Child Health Outcomes: A Systematic Review of the Literature
Pediatrics,
November 1, 2009;
124(Supplement_3):
S265 - S274.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Ishikawa, E. Yano, S. Fujimori, M. Kinoshita, T. Yamanouchi, M. Yoshikawa, Y. Yamazaki, and T. Teramoto
Patient health literacy and patient-physician information exchange during a visit
Fam. Pract.,
October 7, 2009;
(2009)
cmp060v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Krishnan, R. Nowak, S. Q. Davis, and M. Schatz
Anti-inflammatory Treatment after Discharge Home from the Emergency Department in Adults with Acute Asthma
Proceedings of the ATS,
August 1, 2009;
6(4):
380 - 385.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. K. Smith, R. L. Sudore, and E. J. Perez-Stable
Palliative Care for Latino Patients and Their Families: Whenever We Prayed, She Wept
JAMA,
March 11, 2009;
301(10):
1047 - 1057.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. W. Jack, V. K. Chetty, D. Anthony, J. L. Greenwald, G. M. Sanchez, A. E. Johnson, S. R. Forsythe, J. K. O'Donnell, M. K. Paasche-Orlow, C. Manasseh, et al.
A Reengineered Hospital Discharge Program to Decrease Rehospitalization: A Randomized Trial
Ann Intern Med,
February 3, 2009;
150(3):
178 - 187.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. M. Jeppesen, J. D. Coyle, and W. F. Miser
Screening Questions to Predict Limited Health Literacy: A Cross-Sectional Study of Patients With Diabetes Mellitus
Ann. Fam. Med,
January 1, 2009;
7(1):
24 - 31.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. S. Shah, M. N. Lutfiyya, J. E. McCullough, E. Henley, H. J. Zeitz, and M. S. Lipsky
Who is providing and who is getting asthma patient education: an analysis of 2001 National Ambulatory Medical Care Survey data
Health Educ. Res.,
October 1, 2008;
23(5):
803 - 813.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Schillinger, H. Hammer, F. Wang, J. Palacios, I. McLean, A. Tang, S. Youmans, and M. Handley
Seeing in 3-D: Examining the Reach of Diabetes Self-Management Support Strategies in a Public Health Care System
Health Educ Behav,
October 1, 2008;
35(5):
664 - 682.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. Fiscella and R. M. Epstein
So Much to Do, So Little Time: Care for the Socially Disadvantaged and the 15-Minute Visit
Arch Intern Med,
September 22, 2008;
168(17):
1843 - 1852.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L K. Hironaka and M. K Paasche-Orlow
The implications of health literacy on patient-provider communication
Arch. Dis. Child.,
May 1, 2008;
93(5):
428 - 432.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. B. Diette and C. Rand
The Contributing Role of Health-Care Communication to Health Disparities for Minority Patients With Asthma
Chest,
November 1, 2007;
132(5_suppl):
802S - 809S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Schillinger
Misunderstanding Prescription Labels: The Genie Is Out of the Bottle
Ann Intern Med,
December 19, 2006;
145(12):
926 - 928.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. E. Wenzel and R. Covar
Update in asthma 2005.
Am. J. Respir. Crit. Care Med.,
April 1, 2006;
173(7):
698 - 706.
[Full Text]
[PDF]
|
|
|
Copyright © 2005 American Thoracic Society
|
|
|
