Association of Health Literacy and Health Care Utilization Among Glaucoma Patients.
AI Summary
This study found low health literacy in glaucoma patients was linked to fewer follow-up visits, more medication classes, and higher medication costs, underscoring the need for improved patient education.
Abstract
Prcis: Among 7846 adults with self-reported glaucoma, low health literacy (LHL) was associated with fewer outpatient ophthalmological follow-up visits, utilization of a greater number of ocular hypotensive medication classes, and higher costs for glaucoma medications.
Purpose
Previous studies found LHL is associated with increased difficulty with treatment adherence among adults with glaucoma, which can lead to poor outcomes. This study examined patterns of glaucoma health care utilization associated with LHL.
Methods
We analyzed 7846 adults with self-reported glaucoma enrolled in the 1996-2017 Medical Expenditure Panel Survey. Adult glaucoma patients with LHL (defined by National Assessment of Adult Literacy score <226) were the compared with those with high health literacy. Multivariable regression models were constructed to examine the association of LHL with number of outpatient glaucoma visits, prescription medications, polypharmacy (≥2 ocular hypotensive classes prescribed), and associated costs.
Results
Self-reported glaucoma diagnosis was associated with higher rates of LHL [23.9% vs. 9.7%, odds ratio (95% CI): 2.43 (2.25-2.62), P <0.0001]. Among those with glaucoma, LHL was associated with fewer glaucoma outpatient visits [risk ratio: 0.94 (0.89-0.99), P =0.02] and the use of a greater number of ocular hypotensive medications [1.06 (1.01-1.12), P =0.03]. Moreover, those with LHL had higher health care spending on prescription medications [mean: $556.40 vs. $471.87, β (95% CI): $57.05 ($30.22-$83.87)]. Adult glaucoma patients with LHL were also more likely to have polypharmacy [odds ratio (95% CI): 1.26 (1.01-1.59)].
Conclusion
LHL was more prevalent in patients with glaucoma, compared with those without. Glaucoma patients with LHL were prescribed more medications and had higher medication costs, however, they had fewer outpatient glaucoma visits. Improved glaucoma patient education to address LHL is needed, in addition to studies to understand the impact of these findings on treatment outcomes.
MeSH Terms
Shields Classification
Key Concepts6
Low health literacy (LHL) was associated with fewer outpatient ophthalmological follow-up visits, utilization of a greater number of ocular hypotensive medication classes, and higher costs for glaucoma medications among 7846 adults with self-reported glaucoma.
Self-reported glaucoma diagnosis was associated with higher rates of low health literacy (LHL) [23.9% vs. 9.7%, odds ratio (95% CI): 2.43 (2.25-2.62), P <0.0001].
Among adults with self-reported glaucoma, low health literacy (LHL) was associated with fewer glaucoma outpatient visits [risk ratio: 0.94 (0.89-0.99), P =0.02].
Among adults with self-reported glaucoma, low health literacy (LHL) was associated with the use of a greater number of ocular hypotensive medications [1.06 (1.01-1.12), P =0.03].
Adult glaucoma patients with low health literacy (LHL) had higher health care spending on prescription medications [mean: $556.40 vs. $471.87, β (95% CI): $57.05 ($30.22-$83.87)].
Adult glaucoma patients with low health literacy (LHL) were more likely to have polypharmacy (defined as ≥2 ocular hypotensive classes prescribed) [odds ratio (95% CI): 1.26 (1.01-1.59)].
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