Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study.
Chronic obstructive pulmonary disease
Cognition
Health literacy
Self care
Journal
Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438
Informations de publication
Date de publication:
Historique:
received:
01
11
2018
revised:
05
02
2019
accepted:
07
02
2019
pubmed:
10
3
2019
medline:
20
8
2020
entrez:
10
3
2019
Statut:
ppublish
Résumé
Low rates of adherence to self-management behaviors are common among patients with COPD. Health literacy and cognitive abilities may influence engagement in self-management behaviors. We sought to assess the association between health literacy and cognitive abilities with self-management behaviors in patients with COPD. We conducted an observational cohort study among American adults with COPD in New York, New York, and Chicago, Illinois. Outcomes included adherence to COPD medication, metered dose inhaler (MDI) and dry powder inhaler (DPI) technique, receipt of vaccination, and routine healthcare appointments. Health literacy was measured with the Short Test of Functional Health Literacy in Adults. Cognitive function was assessed in terms of global, fluid (working memory, processing speed, executive function) and crystallized (verbal) ability. Adequate health literacy was associated with adequate adherence to COPD medications (OR 1.46; 95% CI, 1.02-2.08), correct MDI (OR 1.66; 95% CI, 1.13-2.44) and DPI (OR 2.17; 95% CI, 1.30-3.64) technique. Fluid abilities were also associated with medication behaviors and visiting a regular healthcare provider, while crystalized abilities were not. Global cognitive abilities were associated with correct inhaler technique. No other associations were found with non-medication self-management behaviors. COPD patients with limited health literacy and deficits in fluid cognitive abilities have lower rates of adherence and poorer inhaler technique than individuals with adequate health literacy and greater fluid cognitive abilities. These findings highlight the importance of considering the health literacy level and cognitive ability when caring for and educating patients with COPD.
Identifiants
pubmed: 30850277
pii: S0954-6111(19)30042-3
doi: 10.1016/j.rmed.2019.02.006
pmc: PMC6693986
mid: NIHMS1523305
pii:
doi:
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
105630Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL105385
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001422
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.
Références
Chest. 2005 Nov;128(5):3198-204
pubmed: 16304262
Ann Pharmacother. 2004 Sep;38(9):1369-76
pubmed: 15266038
J Psychiatr Res. 1975 Nov;12(3):189-98
pubmed: 1202204
Contemp Clin Trials. 2015 Sep;44:103-111
pubmed: 26238181
Chest. 2005 Jun;127(6):1890-7
pubmed: 15947299
Med Care. 2009 Feb;47(2):243-9
pubmed: 19169126
Psychol Aging. 1993 Dec;8(4):517-26
pubmed: 8292280
Am J Respir Crit Care Med. 2013 Feb 15;187(4):347-65
pubmed: 22878278
N Engl J Med. 2007 Mar 29;356(13):1344-51
pubmed: 17392304
Psychol Aging. 2002 Jun;17(2):299-320
pubmed: 12061414
J Geriatr Psychiatry Neurol. 1999 Winter;12(4):168-79
pubmed: 10616864
Int J Chron Obstruct Pulmon Dis. 2016 Mar 16;11:543-51
pubmed: 27042043
J Gen Intern Med. 2012 Oct;27(10):1300-7
pubmed: 22566171
J Gen Intern Med. 2012 Oct;27(10):1317-25
pubmed: 22592354
Cochrane Database Syst Rev. 2014 Mar 19;(3):CD002990
pubmed: 24665053
Int J Chron Obstruct Pulmon Dis. 2016 Dec 22;12:115-122
pubmed: 28053521
Ann Intern Med. 2011 Jul 19;155(2):97-107
pubmed: 21768583
J Gen Intern Med. 2011 Jun;26(6):635-42
pubmed: 21249463
J Gen Psychol. 2007 Jan;134(1):43-65
pubmed: 17283854
Patient Educ Couns. 1999 Sep;38(1):33-42
pubmed: 14528569
JAMA Intern Med. 2017 Apr 1;177(4):585-588
pubmed: 28241217
Ann Allergy Asthma Immunol. 2010 Feb;104(2):132-8
pubmed: 20306816
Clin Interv Aging. 2014;9:23-30
pubmed: 24376347
Natl Vital Stat Rep. 2015 Aug 31;64(10):1-93
pubmed: 26759854
Patient Educ Couns. 2010 Sep;80(3):393-8
pubmed: 20688454
Chronic Obstr Pulm Dis. 2016;3(3):620-627
pubmed: 27981230
Chest. 2013 Jul;144(1):119-127
pubmed: 23349026
J Asthma. 1998;35(3):273-9
pubmed: 9661680
Arch Intern Med. 2003 Jan 13;163(1):83-90
pubmed: 12523921
J Health Commun. 2011;16 Suppl 3:73-88
pubmed: 21951244
J Am Geriatr Soc. 1999 Feb;47(2):172-83
pubmed: 9988288
Popul Health Manag. 2011 Apr;14(2):99-106
pubmed: 21091367
J Gen Intern Med. 2013 Jan;28(1):74-81
pubmed: 22890622
Eur J Clin Pharmacol. 2012 Oct;68(10):1365-73
pubmed: 22476392
Ann Am Thorac Soc. 2016 Jun;13(6):816-24
pubmed: 26998961
J Gen Intern Med. 2018 Apr;33(4):510-523
pubmed: 29427178
Health Psychol. 2010 Jan;29(1):50-5
pubmed: 20063935
Int J Chron Obstruct Pulmon Dis. 2010 Sep 07;5:263-9
pubmed: 20856825
Ann Intern Med. 2011 Aug 2;155(3):179-91
pubmed: 21810710
Chest. 2015 May;147(5):1307-1315
pubmed: 25275432
Med Care. 2002 Sep;40(9):771-81
pubmed: 12218768
J Am Geriatr Soc. 2016 May;64(5):1133-5
pubmed: 27225365
Chest. 1991 Apr;99(4):837-41
pubmed: 2009784
J Community Health. 2009 Aug;34(4):321-7
pubmed: 19353250
BMC Public Health. 2012 Jan 25;12:80
pubmed: 22276600
Ann Allergy Asthma Immunol. 2009 Oct;103(4):325-31
pubmed: 19852197
J Am Geriatr Soc. 2014 May;62(5):872-9
pubmed: 24779482