Hanan Aboumatar|Kathryn A. Carson|Mary Catherine Beach|Debra Roter|Lisa A. Cooper
The Impact of Health Literacy on Desire for Participation in Healthcare, Medical Visit Communication, and Patient Reported Outcomes among Patients with Hypertension
Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University
low health literacy hl associated poor healthcare outcomes mechanisms associations remain unclear elucidate hl influences patients interest participating healthcare medical visit communication patient reported visit outcomes crosssectional study enrollment data randomized controlled trial interventions improve patient adherence hypertension treatments participants 41 primary care physicians 275 patients prior enrollment visit physicians received minimal intervention communication skills training patients received minimal intervention previsit coaching session resulted four intervention groups minimal patientminimal physician minimal patientintensive physician intensive patientminimal physician intensive patientintensive physician rapid estimate adult literacy medicine patients desire involvement decision making communication behaviors patient ratings participatory decision making pdm trust satisfaction lower percentage patients low versus adequate literacy controlled blood pressure groups similarly interested participating medical decision making communication behaviors differ based hl except medical question asking patients lower among low literacy patients particularly true intensive patient intensive physician group 385 vs 642 questions p 0002 overall ratings care didnt differ based hl however analyses stratified intervention assignment patients low literacy minimal physician intervention groups reported significantly lower pdm scores adequate literacy patients patients low adequate literacy similarly interested participating medical decision making however low literacy patients less likely experience pdm visits low literacy patients intensive physician intervention groups asked fewer medical questions patients low literacy may less able respond physicians use patientcentered communication approaches adequate literacy patients