Health literacy and adherence to the pharmacological treatment by people with arterial hypertension.
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ABSTRACT: Objective
To analyze the association between health literacy and the adherence to the pharmacological treatment of Brazilians with arterial hypertension.Methods
Cross-sectional study with 234 participants who responded an on-line sociodemographic and clinical characterization questionnaire, in addition to evaluation of health literacy and of the adherence to their pharmacological treatment. Data were analyzed using descriptive statistics and difference and correlation tests.Results
People with post-graduation, who were actively working and did not smoke, had better health literacy results. Elders and those who were retired or lived on government subsidies adhered better to the medication treatment. There was a correlation between the numerical dimension (rs=0.189; p=0.004) and the global health literacy result (r2=0.170; p=0.009) with the adherence.Conclusions
A better numerical and global understanding of health literacy was associated with better adherence to arterial hypertension medication treatment.
SUBMITTER: Silva ICD
PROVIDER: S-EPMC9749777 | biostudies-literature | 2022
REPOSITORIES: biostudies-literature
Publications
Health literacy and adherence to the pharmacological treatment by people with arterial hypertension.
Silva Iorana Candido da ICD Nogueira Maria Rayssa do Nascimento MRDN Cavalcante Tahissa Frota TF Felipe Gilvan Ferreira GF Morais Huana Carolina Cândido HCC Moreira Rafaella Pessoa RP Oliveira Andressa Suelly Saturnino de ASS
Revista brasileira de enfermagem 20220808 6
<h4>Objective</h4>To analyze the association between health literacy and the adherence to the pharmacological treatment of Brazilians with arterial hypertension.<h4>Methods</h4>Cross-sectional study with 234 participants who responded an on-line sociodemographic and clinical characterization questionnaire, in addition to evaluation of health literacy and of the adherence to their pharmacological treatment. Data were analyzed using descriptive statistics and difference and correlation tests.<h4>R ...[more]
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Project description:Rationale, aims, and objectivesClinical studies show equivalent health outcomes from interventional procedures and treatment with medication only for stable angina patients. However, patients may be subject to overuse or access barriers for interventional procedures and may exhibit suboptimal adherence to medications. Our objective is to evaluate whether community-level health literacy is associated with treatment selection and medication adherence patterns.MethodThe sample included Medicare fee-for-service beneficiaries (20% random sample) with stable angina in 2007-2013. We used an area-level health literacy variable because of the lack of an individual measure in claims. We measured the association between (a) area-based health literacy with treatment selection (medication only, percutaneous coronary intervention [PCI], or coronary artery bypass grafting (CABG) surgery) and (b) area-based health literacy with medication adherence. We controlled for other factors including demographics, co-morbidity burden, dual eligibility, and area deprivation index.ResultsWe identified 8300 patients of whom 8.7% lived in a low health literacy area. Overall, 56% of patients received medication only, 28% received PCI, and 15% received CABG. Patients in low health literacy areas were less likely to receive CABG (-3.5 percentage points; 95% CI, -6.8 to -0.3) than were patients in high health literacy areas, but the significance was sensitive to specification. Overall, 81.5% and 71.5% of patients were adherent to antianginals and statins, respectively. Living in low health literacy areas was associated with lower adherence to antianginals (-3.3 percentage points; 95% CI, -6.1 to -0.6) but not statins.ConclusionsLow area-based health literacy was associated with being less likely to receive CABG and lower adherence, but the differences between low and high health literacy areas were small and sensitive to model specification. Individual factors such as dual eligibility status and race/ethnicity had stronger associations with outcomes than had area-based health literacy, suggesting that this area-based measure was inadequate to account for social determinants in this study.
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Project description:ObjectiveThe aim of this study was to summarize the evidence of health literacy and health outcomes in hypertensive patients.MethodsArticles published in English were searched from six databases: MEDLINE, CINAHL, Embase, ERIC, psycINFO, and SCOPUS. The articles published up to September 2017 were included.ResultsNineteen publications were included in the review. There was quality and consistent evidence that hypertensive patients with lower literacy had poorer knowledge. There was inconsistent evidence to show the relationship between health literacy and clinical outcomes, of systolic and diastolic blood pressure, and blood pressure control; behavioral outcomes, of self-care, self-efficacy, adherence; patient-physician interactions outcomes, of patient-physician communication, patient trust, involvement in decision making and other outcomes.ConclusionThe person with low health literacy is likely to have poor knowledge of hypertension. However, there is insufficient evidence to suggest that health literacy is associated with outcomes of hypertension independently.
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Project description:Pulmonary arterial hypertension (PAH), a fatal disease, is characterized by pulmonary vascular remodeling and vascular resistance. However, the molecular mechanisms underlying the pathogenesis of PAH remained to be incompletely understood. RNA-seq, 4D Label-free proteomics and phosphoproteomics were used to detect the levels of mRNA, proteins, and phosphoproteins in lung tissues from PAH patients, respectively. Parallel reaction monitoring (PRM) was carried out to verify the expression of the differentially expressed proteins. In total, 967 differentially expressed genes (|log2FoldChange|>1 and p<0.05), 764 differentially expressed proteins and 411 phosphoproteins were observed after data filtering (|log2FoldChange|>1 and p<0.05) in lung tissues of PAH patients as compared with the control group. Integrated analysis of the three omic measures revealed that the biological processes involving inflammation, ion channel and metabolism were closely associated with PAH. Several signaling pathways, such as ferroptosis, HIF-1, PI3K-AKT, and Rap1 might be related to the development of PAH. This study combined multi-omics characteristic profiling to find out the changed genes or proteins that contributed to a detailed pathogenic of PAH. It would have the benefit of looking for the novel and effective treatment targets and therapeutic drugs for PAH patients.
2025-09-03 | GSE272776 | GEO
Project description:BackgroundPrevious studies have examined the associations of health literacy and social support with medication adherence among patients with hypertension. However, limited evidence exists regarding the mechanisms underlying the relationship between these factors and medication adherence.PurposeTo explore the prevalence of medication adherence and its determinants in patients with hypertension in Shanghai.MethodsA community-based cross-sectional study was conducted among 1697 participants with hypertension. We collected sociodemographic and clinical characteristics as well as data regarding health literacy, social support, and medication adherence using questionnaires. We examined interactions among the factors using a structural equation model.ResultsThe participants included 654 (38.54%) patients with a low degree of medication adherence and 1043 (61.46%) patients with a medium/high degree of adherence. Social support directly influenced adherence (β = 0.165, P < 0.001) and indirectly influenced adherence through health literacy (β = 0.087, P < 0.001). Health literacy directly influenced adherence (β = 0.291, P < 0.001). Education indirectly affected adherence through both social support (β = 0.048, P < 0.001) and health literacy (β = 0.080, P < 0.001). Moreover, there was a sequential mediating effect of social support and health literacy on the association between education and adherence (β = 0.025, P < 0.001). After controlling for age and marital status, similar results were also obtained, indicating a good model fit.ConclusionsThe degree of medication adherence among hypertensive patients needs to improve. Health literacy and social support had both direct and indirect effects on adherence, and thus, these factors should be considered as tools to improve adherence.
| S-EPMC9940429 | biostudies-literature
Project description:Background Pharmacologic treatment for pulmonary arterial hypertension (PAH) improves exercise capacity, functional class, and hemodynamic indexes. However, monthly prescription costs often exceed $4000. We examined associations between (1) medication copayment and (2) annual household income with adherence to pulmonary vasodilator therapy among individuals with PAH. Methods and Results We used administrative claims data from an insured population in the United States to identify individuals diagnosed with PAH between 2015 and 2020. All individuals had ≥1 medication claim for endothelin receptor antagonists, phosphodiesterase type-5 inhibitors, prostanoids or prostacyclin receptor agonists, or the soluble guanylate cyclase stimulator riociguat. We defined copayments as low, medium, or high, as determined by their distributions for each medication class. Annual household income was categorized as <$40 000, $40 000 to $74 999, and ≥$75 000. The primary outcome was medication adherence, defined by proportion of days covered ≥80%. We studied 4025 adults (aged 65.9±13.3 years; 71.2% women). Compared with those with annual household income ≥$75 000, individuals in the <$40 000 and $40 000 to $74 999 categories had no significant differences in medication adherence. Compared with those with low copayments, individuals with high copayments had decreased adherence to prostanoids (odds ratio [OR], 0.36 [95% CI, 0.20-0.65]; P<0.001) and combination therapy with endothelin receptor antagonist and phosphodiesterase type-5 inhibitor (OR, 0.61 [95% CI, 0.38-0.97]; P=0.03). Conclusions We identified associations between copayment and adherence to prostanoids and combination therapy among individuals with PAH. Copayment may be a structural barrier to medication adherence and merits inclusion in studies examining access to pharmacotherapy among individuals with PAH.
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