The association between health literacy and outcomes of care among epilepsy patients

Purpose: To determine the association between health literacy and outcomes of care (seizure control and quality of life) in individuals with epilepsy followed at a level four epilepsy center. Methods: We conducted a face-to-face interview of patients seen at the Comprehensive Epilepsy Program of the University of Florida HSC/Jacksonville. We obtained demographic and clinical data, administered the Quality of Life in Epilepsy-10 inventory, and performed the Liverpool Seizure Severity Scale. We asked three screening questions taken from the Short Test of Functional Literacy in Adults. Using each health literacy question as the target variable we determined the predictor variables that were associated with responses to these questions and performed multiple linear regression to determine those that retained their significance. Results: One hundred and forty adult patients with epilepsy comprised the study population. On univariate analysis, patients who did poorly on questions for health literacy that included difficulty reading hospital materials and difficulty filling out medical forms had lower scores on the QOLIE-10 and lower annual household incomes. This significance was maintained on multivariate analysis. Those who had problems learning about their medical condition due to difficulties understanding written information had poorer scores on the QOLIE-10, increased seizure frequency, and lower educational levels on univariate analysis. However, on multivariate analysis, only poorer scores on quality of life were independently significant. Conclusion: Patients with epilepsy who have limited health literacy do not necessarily have poorer seizure control but have lower quality of life scores. (C) 2009 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.