Exploration of Predictors of Limited Health Literacy in Dupuytren's Patients
Mélissa Roy, MDCM
University of Toronto, Toronto, ON, Canada
PURPOSE: Health literacy (HL) represents the degree to which patients can understand and act upon health information and has a clear impact on clinical outcomes, patient satisfaction, and decision making. This study aims to identify predictors of limited health literacy in the Dupuytren's patient population.
METHODS: This cross-sectional study was performed at the Toronto Western's Hospital's Hand Program, Canada. Patients with a clinical diagnosis of Dupuytren's and self-reported fluency in English were included. We selected the Newest Vital Sign (NVS), a rapid, validated, and reliable screening tool previously used in the hand surgery literature, in order to measure HL. Limited health literacy was defined as a score of 3 or less out of 6. An exploratory multivariable logistic regression model was applied in order to identify possible predictors.
RESULTS: A total of 172 patients participated in the study and from those, 44% (n=76) had limited health literacy (see Figure 1 for HL distribution). Patients with limited health literacy were more likely to be older (67 vs 62 years, p=0.003). The proportion of patients with a maternal language other than English was higher in the limited HL group (32% vs 13%, p=0.002). The proportion of patients in the lower income quintiles and with lower education levels was significantly higher in the limited health literacy group (p<0.001 and p=0.009). Only one independent predictor of limited health literacy was found. Being in the lower three income quintiles had a nearly 6-fold increase in the odds of having limited HL compared with the highest two income quintiles. Age, maternal language, education, comorbidities and employment status were not found to be independent predictors of limited HL.
CONCLUSION: Our study reveals a very high prevalence of limited health literacy (44%) amongst the Dupuytren's patient population. It is clear that universal measure of support would be of high value when communicating and caring for all Dupuytren’s patients as many have limited health literacy.
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