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Low health literacy may skew perception of diabetes control
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Patients with poorly controlled type 2 diabetes and low health literacy may believe they are doing well and, therefore, be less likely to make the necessary changes to improve their glucose measurements, according to research published in The Diabetes Educator.
Results from a cross-sectional analysis of patients recruited from primary care practices suggest providers and educators should consider health literacy when discussing diabetes control and setting management goals with patients, according to researchers.
“The findings from this study suggest that recognizing just how common low health literacy is in patients with diabetes is important for diabetes educators and should thus inform communication strategies regarding HbA1c and the control of diabetes,” the researchers wrote.
Monica O. Ferguson, MSHP, MD, of the division of general internal medicine, department of medicine, at the University of Pennsylvania in Philadelphia, and colleagues studied 280 adults with type 2 diabetes and HbA1c levels greater than 8% in their two most recent measurements.
Through in-person interviews, the researchers assessed perceived diabetes control and factors potentially related to this outcome, including health literacy. The Rapid Estimate of Adult Literacy in Medicine survey was used to measure patient health literacy.
Thirty-nine percent of patients held the belief they were managing to control their diabetes well or very well. Among those at the seventh- to eighth-grade health literacy level, the proportion rose to 57%, and among patients with health literacy at the level of sixth grade and below, it continued higher to 61%.
“The study findings also suggest that patients use nonclinical cues, such as performing self-management behaviors, rather than clinical measures, such as HbA1c, to determine how well they are managing to control their disease,” the researchers wrote.
Providers and educators can optimize how they teach and motivate by becoming aware of their patients’ understanding of control and the cues they use to determine it, according to the researchers.
The findings could inform interventions for improving control of not only diabetes, but other chronic conditions.
“Effective communication strategies appropriate for all patients regardless of their health literacy are essential, and these strategies must improve the accuracy of perceived control in poorly controlled patients,” the researchers wrote. – by Allegra Tiver
Disclosure: The researchers report no relevant financial disclosures.
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