Published in:
01-11-2007 | Original Article
Limited Health Literacy is a Barrier to Medication Reconciliation in Ambulatory Care
Published in: Journal of General Internal Medicine | Issue 11/2007
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Background
Limited health literacy may influence patients’ ability to identify medications taken; a serious concern for ambulatory safety and quality.
Objective
To assess the relationship between health literacy, patient recall of antihypertensive medications, and reconciliation between patient self-report and the medical record.
Design
In-person interviews, literacy assessment, medical records abstraction.
Participants
Adults with hypertension at three community health centers.
Measurement
We measured health literacy using the short-form Test of Functional Health Literacy in Adults. Patients were asked about the medications they took for blood pressure. Their responses were compared with the medical record.
Results
Of 119 participants, 37 (31%) had inadequate health literacy. Patients with inadequate health literacy were less able to name any of their antihypertensive medications compared to those with adequate health literacy (40.5% vs 68.3%, p = 0.005). After adjusting for age and income, this difference remained (adjusted odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 1.3–6.7). Agreement between patient reported medications and the medical record was low: 64.9% of patients with inadequate and 37.8% with adequate literacy had no medications common to both lists.
Conclusions
Limited health literacy was associated with a greater number of unreconciled medications. Future studies should investigate how this may impact safety and hypertension control.