Matteo Fabbri|M. Hassan Murad|Alexandra Wennberg|Pierpaolo Turcano|Patricia J. Erwin|Fares Alahdab|Alvise Berti|Sheila M. Manemann|Kathleen J. Yost|Lila J. Finney Rutten|Véronique L. Roger
Health Literacy and Outcomes Among Patients With Heart Failure
purpose study determine health literacy associated mortality hospitalizations emergency department ed visits among patients living heart failure hf growing evidence suggests association health literacy healthrelated outcomes patients hf searched embase medline psycinfo ebsco cinahl inception january 1 2019 help medical librarian eligible studies evaluated health literacy among patients hf assessed mortality hospitalizations ed visits causes exclusion time geography language two reviewers independently selected studies extracted data assessed methodological quality identified studies included 15 studies 11 overall high methodological quality among observational studies average 24 patients inadequate marginal health literacy inadequate health literacy associated higher unadjusted risk mortality risk ratio rr 167 95 confidence interval ci 118 236 hospitalizations rr 119 95 ci 109 129 ed visits rr 117 95 ci 103 132 adjusted measurements combined inadequate health literacy remained statistically associated mortality rr 141 95 ci 106 188 hospitalizations rr 112 95 ci 101 125 among 4 interventional studies 2 effectively improved outcomes among patients inadequate health literacy study estimated prevalence inadequate health literacy high inadequate health literacy associated increased risk death hospitalizations findings important clinical public health implications warrant measurement health literacy deployment interventions improve outcomes