Alex D. Federman|Michael S. Wolf|Anastasia Sofianou|Melissa Martynenko|Rachel O’Connor|Ethan A. Halm|Howard Leventhal|Juan P. Wisnivesky
Self-Management Behaviors in Older Adults with Asthma: Associations with Health Literacy
Icahn School of Medicine at Mount Sinai|Northwestern University|Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai|Northwestern University|The University of Texas Southwestern Medical Center|Rutgers, The State University of New Jersey|Icahn School of Medicine at Mount Sinai
objectives examine selfmanagement behaviors including medication adherence inhaler technique older adults asthma association health literacy design observational cohort study setting primary care pulmonary specialty practices two tertiary academic medical centers three f ederally q ualified h ealth c enters n ew ork n ew ork c hicago llinois participants adults moderate severe persistent asthma aged 60 older n 433 measurements outcomes adherence asthma controller medications metered dose inhaler mdi dry powder inhaler dpi techniques usual asthma physician avoidance four common triggers health literacy assessed using hort est f unctional h ealth l iteracy dults results mean age 67 36 participants marginal low health literacy adherence low 38 overall worse individuals low health literacy 22 adequate literacy 47 p lt 001 adjusting demographic factors health status odds ratio 048 95 confidence interval ci 031073 similarly inhaler technique poor 38 54 good mdi dpi technique respectively technique worse low health literacy mdi technique 057 95 ci 038085 dpi technique 042 95 ci 025071 asthma selfmonitoring avoidance triggers occurred infrequently less consistently associated low health literacy conclusion adherence medications inhaler technique poor older adults asthma worse low health literacy clinicians routinely assess controller medication adherence inhaler technique use lowliteracy communication strategies support selfmanagement older adults asthma