Glaucoma Patients With Poor Health Literacy May Have Greater Disease Progression
May 14, 2008
Adapted from the JAMA and Archives Journals
Glaucoma patients in
urban areas who have poor health literacy appear to miss more appointments and
to have worse disease understanding and greater disease progression than
patients with adequate health literacy, according to a report in the May 2008
issue of Archives of Ophthalmology, one of the JAMA/Archives
Mark S. Juzych, M.D., M.H.S.A., of the Kresge Eye Institute,
Wayne State University, Detroit, and colleagues used a standardized test to
determine the health literacy of 204 English-speaking patients treated for
glaucoma for at least one year. Patients' demographic information and glaucoma
understanding were assessed through an oral questionnaire.
Of the 204
glaucoma patients, half were categorized as having poor health literacy and the
other half were categorized as having adequate health literacy. "Being of white
race, having an education of some college or more and having a household income
of $20,000 or greater was associated with a lower likelihood of having poor
health literacy," the authors write.
On average, the poor literacy group
had lower glaucoma understanding, missed more appointments per year and reported
having missed taking eye drops more frequently than those in the adequate
literacy group, with 65 patients having missed taking eye drops two or more
times per month compared with only 34 patients in the adequate literacy group.
Patients with poor health literacy also showed greater visual field loss at the
beginning of the study and significantly worse visual field parameters when
comparing recent and initial visual fields.
"Closing the gap in health
literacy is one essential component in reducing disparities in glaucoma care.
Screening patients for poor literacy is a first step," the authors conclude.
"However, the real challenge is in shaping effective public health communication
that is culturally and linguistically appropriate for patients and promotes
compliance with medications and follow-up treatment with their
"In addition, there is a need to improve physician
communication, which should consider the needs and competencies of patients with
poor health literacy."
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