Russell L. Rothman
Influence of Patient Literacy on the Effectiveness of a Primary Care–Based Diabetes Disease Management Program
low literacy important barrier patients diabetes interventions address low literacy well examinedto examine role literacy effectiveness comprehensive disease management program patients diabetesanalysis influence literacy glycemic control systolic blood pressure using data randomized controlled trial conducted february 2001 april 2003 comprehensive diabetes management program participants 217 patients aged 18 years older type 2 diabetes poor glycemic control glycosylated hemoglobin hba1c levels 80 presenting us academic general internal medicine practiceall communication patients individualized delivered enhance comprehension among patients low literacy intervention patients received intensive disease management multidisciplinary team control patients received initial management session continued usual careachievement goal hba1c levels systolic blood pressure 12month followup control intervention patients stratified literacy statuscomplete 12month data available 193 patients 89 among patients low literacy intervention patients likely control patients achieve goal hba1c levels 70 42 vs 15 respectively adjusted odds ratio 46 95 confidence interval ci 13 172 p 02 patients higher literacy similar odds achieving goal hba1c levels regardless intervention status 24 vs 23 adjusted 10 95 ci 04 25 p 98 improvements systolic blood pressure similar literacy statusliteracy may important factor predicting benefit intervention diabetes management diabetes disease management program addresses literacy may particularly beneficial patients low literacy increasing access program could help reduce health disparities