Lauren E. Woodard|Cassie R. Landrum|Amber B. Amspoker|David J. Ramsey|Aanand D. Naik
Interaction between functional health literacy, patient activation, and glycemic control
Michael E. DeBakey VA Medical Center|Michael E. DeBakey VA Medical Center|Michael E. DeBakey VA Medical Center|Michael E. DeBakey VA Medical Center|Michael E. DeBakey VA Medical Center
functional health literacy fhl patient activation impact diabetes control enhanced diabetes selfmanagement less known combined effect characteristics diabetes outcomes using brief validated measures examined interaction fhl patient activation predicting glycosylated hemoglobin hba1c control among cohort multimorbid diabetic patientswe administered survey via mail 387 diabetic patients coexisting hypertension ischemic heart disease received outpatient care one regional va medical center november 2010 december 2010 identified patients study conditions using international classification diseasesninth revisionclinical modification icd9cm diagnoses codes current procedure terminology cpt procedures codes surveys returned 195 504 patients determined patient activation levels based participant responses 13item patient activation measure fhl levels using singleitem screening question confident filling medical forms reviewed patient medical records assess glycemic control used multiple logistic regression examine whether activation fhl individually jointly related hba1c controlneither patient activation fhl independently related glycemic control unadjusted main effects model however interaction two significantly associated glycemic control odds ratio 105 95 confidence interval 101109 p002 controlling age illness burden number primary care visits combined effect measures glycemic control remained significant odds ratio 105 95 confidence interval 101109 p002the interaction fhl patient activation associated hba1c control beyond independent effects parameters alone personalized approach diabetes management incorporating characteristics may increase patientcentered care improve outcomes patients diabetes