Article

Health literacy and adherence to glaucoma therapy.

Duke University Eye Center, Durham, North Carolina 27710, USA.
American Journal of Ophthalmology (impact factor: 4.22). 09/2006; 142(2):223-6. DOI:10.1016/j.ajo.2006.03.018 pp.223-6
Source: PubMed

ABSTRACT To describe the health literacy of subjects with open angle glaucoma and to investigate the hypothesis that low health literacy is associated with poor glaucoma medication adherence.
Cross-sectional patient survey and concomitant chart review.
One hundred and ninety-seven subjects with open angle glaucoma participated in a survey which included basic demographic information such as age, gender, ethnicity, and level of education completed, and a test of heath literacy, the Rapid Assessment of Adult Literacy in Medicine. Information was collected regarding visual field tests and prescribed medication. The subjects' pharmacies were contacted to ascertain the number of refills requested over the previous six months.
Although 146 subjects (74%) reported completing high school, only 94 subjects (48.0%) read at or above a ninth grade level; 23 (11.7%) read at a level of third grade or below. The mean number of refills requested by a subject in the preceding six months was not predicted by race (P = .27,) gender (P = .31), age (P = .92), mean deviation of the visual field (P = .36), or level of education (P = .58). There was a positive relationship between health literacy and the number of refills obtained (P = .003).
Many patients with open angle glaucoma may have poor health literacy. The subjects in our study with low literacy were less adherent with their glaucoma medications than those with a higher level of literacy. Interventions specifically targeting patients with low literacy may improve medication adherence.

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    Article: Health literacy and vision-related quality of life.
    K W Muir, C Santiago-Turla, S S Stinnett, L W Herndon, R R Allingham, P Challa, P P Lee
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    ABSTRACT: Non-visual factors influence a person's vision-related quality of life (VRQoL). The purpose of this study was to assess the relationship between health literacy and VRQoL in glaucoma patients. One hundred and ninety-five subjects with open-angle glaucoma participated in a cross-sectional patient survey and chart review. Subjects were administered a test of health literacy, an assessment of physical and mental well-being, and an assessment of VRQoL, the National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25). Charts were reviewed for visual acuity and visual field results. In univariate analyses, older age (p<0.001), non-White race (p<0.001), worse visual acuity (p<0.001), worse visual field scores (p<0.001), lower level of education (p<0.001), worse health literacy (p<0.001) and worse score on the mental health component of the SF-12 (p = 0.005) were associated with worse VFQ-25 scores. In multivariate analyses, only older age was associated with worse total VFQ-25 scores (p<0.001), although the association between health literacy and the VFQ subscale of dependency remained significant (p = 0.04). Individuals with a lower health literacy do not appear to have a worse overall VRQoL compared with those with a higher literacy, but worse health literacy is associated with increased dependency.
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    Kelly W Muir, Cecilia Santiago-Turla, Sandra S Stinnett, Leon W Herndon, R Rand Allingham, Pratap Challa, Paul P Lee
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Keywords

94 subjects
 
Adult Literacy
 
concomitant chart review
 
Cross-sectional patient survey
 
glaucoma medications
 
health literacy
 
heath literacy
 
included basic demographic information
 
low health literacy
 
low literacy
 
mean number
 
ninth grade level
 
open angle glaucoma
 
poor glaucoma medication adherence
 
preceding six months
 
Rapid Assessment
 
subjects' pharmacies
 
third grade
 
visual field
 
visual field tests