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      Alfabetización en la salud en pacientes con prescripción de hipolipemiantes: una mirada desde la atención primaria Translated title: Health literacy in patients with lipid-lowering prescription: a view from primary care

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          Abstract

          Resumen Introducción: La alfabetización en salud es una medida de la capacidad de los pacientes de leer, comprender y tomar decisiones en base a instrucciones médicas. La inadecuada alfabetización se asocia a un peor estado de salud en pacientes con enfermedades crónicas. El momento de la dispensación podría ser una oportunidad para evaluar esta condición por el farmacéutico de atención primaria El objeto de este estudio fue evaluar la relación de alfabetización en salud y los valores de colesterol total y comorbilidades en personas con prescripción de hipolipemiantes atendidos en un centro de jubilados. Método: Se diseñó un estudio prospectivo donde se evaluó la relación de la alfabetización utilizando Short Assessment of Health Literacy for Spanish-speaking Adults y el valor de colesterol , medicamentos , factores de riesgo y comorbilidades. Todas estas variables se analizaron en forma integrada en un análisis multivariado. Resultados: Participaron 178 pacientes, 63% mujeres. El puntaje promedio de SAHLSA fue 43,4 ± 5,5. Se encontró una inadecuada alfabetización en 24%. pacientes El valor promedio de colesterol en estre grupo de pacientes fue 235,17mg/dl vs 193,53mg/dl quienes tenian adecuada alfabetización en salud. Se realizó un análisis multivariado que mostró asociación entre inadecuada alfabetización en salud, bajo nivel de educación y conocimiento del paciente . El número de internaciones y la aparición de eventos coronarios fueron significativamente mayor en los pacientes con alfabetización en salud insuficiente. Conclusiones: Se encontró relación directa entre el grado de alfabetización en salud y los valores de colesterol total en pacientes en tratamiento por hipercolesterolemia.

          Translated abstract

          Abstract Introduction: Health literacy is a measure of the ability of patients to read, understand and make decisions based on medical instructions. Inadequate health literacy is associated with poorer health in patients with chronic diseases. Time of dispensing could be an opportunity for the primary care pharmacist to evaluate this condition by the. The purpose of this study was to evaluate the relationship of Health literacy and the values of total cholesterol and comorbidities in people with a prescription of lipid-lowering drugs treated in a retirement center. Method: A prospective study was designed where the relationship of Health literacy was evaluated using Short Assessment of Health Literacy for Spanish-speaking Adults and the value of cholesterol, medications, risk factors and comorbidities. All these variables were analyzed in an integrated manner in a multivariate analysis. Results: 178 patients participated, 63% women. The mean SAHLSA score was 43.4 ± 5.5. Inadequate HL was found in 24%. patients. The mean cholesterol value in patients with inadequate Health literacy was 235.17mg / dl vs 193.53mg / dl among those with adequate Health literacy. A multivariate analysis was performed that showed an association between inadequate Health literacy, the level of education and the patient’s knowledge of normal values of total cholesterol. The number of hospitalizations and the occurrence of coronary events were significantly higher in patients with insufficient Health literacy. Conclusions: A direct relationship was found between the degree of Health literacy and total cholesterol values in patients undergoing treatment for hypercholesterolemia.

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          The Single Item Literacy Screener: Evaluation of a brief instrument to identify limited reading ability

          Background Reading skills are important for accessing health information, using health care services, managing one's health and achieving desirable health outcomes. Our objective was to assess the diagnostic accuracy of the Single Item Literacy Screener (SILS) to identify limited reading ability, one component of health literacy, as measured by the S-TOFHLA. Methods Cross-sectional interview with 999 adults with diabetes residing in Vermont and bordering states. Participants were randomly recruited from Primary Care practices in the Vermont Diabetes Information System June 2003 – December 2004. The main outcome was limited reading ability. The primary predictor was the SILS. Results Of the 999 persons screened, 169 (17%) had limited reading ability. The sensitivity of the SILS in detecting limited reading ability was 54% [95% CI: 47%, 61%] and the specificity was 83% [95% CI: 81%, 86%] with an area under the Receiver Operating Characteristics Curve (ROC) of 0.73 [95% CI: 0.69, 0.78]. Seven hundred seventy (77%) screened negative on the SILS and 692 of these subjects had adequate reading skills (negative predictive value = 0.90 [95% CI: 0.88, 0.92]). Of the 229 who scored positive on the SILS, 92 had limited reading ability (positive predictive value = 0.4 [95% CI: 0.34, 0.47]). Conclusion The SILS is a simple instrument designed to identify patients with limited reading ability who need help reading health-related materials. The SILS performs moderately well at ruling out limited reading ability in adults and allows providers to target additional assessment of health literacy skills to those most in need. Further study of the use of the SILS in clinical settings and with more diverse populations is warranted.
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            The prevalence of limited health literacy.

            To systematically review U.S. studies examining the prevalence of limited health literacy and to synthesize these findings by evaluating demographic associations in pooled analyses. We searched the literature for the period 1963 through January 2004 and identified 2,132 references related to a set of specified search terms. Of the 134 articles and published abstracts retrieved, 85 met inclusion criteria, which were 1) conducted in the United States with > or =25 adults, 2) addressed a hypothesis related to health care, 3) identified a measurement instrument, and 4) presented primary data. The authors extracted data to compare studies by population, methods, and results. The 85 studies reviewed include data on 31,129 subjects, and report a prevalence of low health literacy between 0% and 68%. Pooled analyses of these data reveal that the weighted prevalence of low health literacy was 26% (95% confidence interval [CI], 22% to 29%) and of marginal health literacy was 20% (95% CI, 16% to 23%). Most studies used either the Rapid Estimate of Adult Literacy in Medicine (REALM) or versions of the Test of Functional Health Literacy in Adults (TOFHLA). The prevalence of low health literacy was not associated with gender (P=.38) or measurement instrument (P=.23) but was associated with level of education (P=.02), ethnicity (P=.0003), and age (P=.004). A pooled analysis of published reports on health literacy cannot provide a nationally representative prevalence estimate. This systematic review exhibits that limited health literacy, as depicted in the medical literature, is prevalent and is consistently associated with education, ethnicity, and age. It is essential to simplify health services and improve health education. Such changes have the potential to improve the health of Americans and address the health disparities that exist today.
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              Health Literacy in Primary Care Practice.

              Health literacy includes a set of skills needed to make appropriate health decisions and successfully navigate the health care system. These skills include reading, writing, numeracy, communication, and, increasingly, the use of electronic technology. National data indicate that more than one-third of U.S. adults have limited health literacy, which contributes to poor health outcomes and affects patient safety, and health care access and quality. Although there are a number of tools that screen for limited health literacy, they are primarily used for research. Routinely screening patients for health literacy has not been shown to improve outcomes and is not recommended. Instead, multiple professional organizations recommend using universal health literacy precautions to provide understandable and accessible information to all patients, regardless of their literacy or education levels. This includes avoiding medical jargon, breaking down information or instructions into small concrete steps, limiting the focus of a visit to three key points or tasks, and assessing for comprehension. Additionally, printed information should be written at or below a fifth- to sixth-grade reading level. Visual aids, graphs, or pictures can enhance patient understanding, as can more concrete presentation of numerical information.
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                Author and article information

                Journal
                ars
                Ars Pharmaceutica (Internet)
                Ars Pharm
                Universidad de Granada (Granada, Granada, Spain )
                2340-9894
                June 2022
                : 63
                : 2
                : 114-125
                Affiliations
                [1] Córdoba Córdoba orgnameUniversidad Católica de Córdoba orgdiv1Facultad de Ciencias Químicas Argentina
                Article
                S2340-98942022000200114 S2340-9894(22)06300200114
                10.30827/ars.v63i2.23470
                84777cf8-c428-4526-a76c-0e3c12e05dc1

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 06 February 2022
                : 14 December 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 12
                Product

                SciELO Spain

                Categories
                Artículos Originales

                hipolipemiantes,hipercolesterolemia,alfabetización en salud,hypercholesterolemia,lipid-lowering,Health Literacy

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