期刊
PATIENT EDUCATION AND COUNSELING
卷 85, 期 3, 页码 499-504出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.pec.2010.12.015
关键词
Aging; Drugs; Prevention; Literacy; Doctor-patient relationship
资金
- Houston Veterans Affairs Health Sciences Research and Development Center of Excellence [HFP90-020]
- National Institute on Aging [K23AG027144]
- Doris Duke Charitable Foundation
- American Gastroenterological Association Foundation-Sucampo-Association
- Department of Veterans Affairs [VA IIR 08-028]
Objectives: To evaluate the effect of functional health literacy (FHL) on preferences for decision-making; and among those initially preferring a passive decision-making role, to explore how preferences change if their physician actively encourages their involvement. Methods: Consecutive older adults with cardiovascular disease receiving complex antithrombotic therapy completed a comprehensive assessment including measures of FHL and preferences for shared decision making. Results: Half of all participants had inadequate or marginal FHL. Those with inadequate FHL were more likely (P = 0.01) to prefer passive rather than active decision making styles even after controlling for age, education, and numeracy. However, 40% of patients preferring passive styles had adequate FHL and these patients were significantly more likely to change their preference to more active styles (odds ratio = 7.17, P < .01) if their physician was more supportive or encouraged participation. Conclusions: Screening FHL can provide insight into patients' preferences for active participation in decision making. Clinicians' encouragement of participation can increase engagement by patients with adequate FHL. Practice implications: We propose an algorithm for screening FHL and preferences for participating in decisions about complex medication regimens. Published by Elsevier Ireland Ltd.
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