| Learning Objective #1: Identify the potential health impact low health literacy has on a patient's ability to interpret prescription instructions | |||
| Learning Objective #2: Understand the importance of assessing health literacy in the clinical setting |
Methods. One hundred twelve adults with asthma (29% White, 66% AA; 82% female; 63% with < high school education, 45% Medicaid recipients, mean age 47 + 13.6 [range 17-80]) were administered the Rapid Estimate of Adult Literacy in Medicine (REALM) and asked to read and interpret a prescription (Rx) for an inhaled corticosteroid (ICS) and rescue inhaler.
Results. The mean REALM score was 56.3 + 13.6 (range 1-66) with 43% of the sample falling at or below the 8th grade reading level (low literacy; REALM score < 60). Twenty (18%) of the subjects were either unable to read the prescriptions or made errors in interpreting the prescriptions. Thirty-five percent of the low literacy group had difficulty reading or interpreting Rx compared to 5% of the literate group (p=.000). AAs were more likely to have low REALM scores (p=.001)and to make errors in reading or interpreting inhaler RX (p=.04) than Caucasians although this may be a function of AAs lower educational attainment compared to Caucasians (p=.000).
Conclusions: AA adults with asthma had lower health literacy than Caucasians; the inability to read or follow Rx directions may lead to inadequate self-management thereby contributing to the greater health disparities seen in AAs with asthma.
1. Williams JAMA, 1995; Chest 1998; Arch Int Med, 1998; 2. Weiss et al J Am Board Fam Pract, 1992; 3. Baker et al, AJPH, 1997;4. Rimer et al, Am J Prev Med, 1991; 5. National Asthma Education and Prevention Program, 1997.
Funding: NHLBI, Bach Foundation