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Health literacy, cognitive function, proper use, and adherence to inhaled asthma controller medications among older adults with asthma.
O'Conor, Rachel; Wolf, Michael S; Smith, Samuel G; Martynenko, Melissa; Vicencio, Daniel P; Sano, Mary; Wisnivesky, Juan P; Federman, Alex D.
Afiliação
  • O'Conor R; Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: r-oconor@northwestern.edu.
  • Wolf MS; Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
  • Smith SG; Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
  • Martynenko M; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Vicencio DP; Department of Medicine, Mercy Hospital and Medical Center, Chicago, IL.
  • Sano M; Division of Pulmonary, Critical Care and Sleep Medicine, James J. Peters VA Medical Center, Bronx, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Wisnivesky JP; Department of Medicine, Mercy Hospital and Medical Center, Chicago, IL.
  • Federman AD; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
Chest ; 147(5): 1307-1315, 2015 May.
Article em En | MEDLINE | ID: mdl-25275432
ABSTRACT

BACKGROUND:

We sought to investigate the degree to which cognitive skills explain associations between health literacy and asthma-related medication use among older adults with asthma.

METHODS:

Patients aged ≥ 60 years receiving care at eight outpatient clinics (primary care, geriatrics, pulmonology, allergy, and immunology) in New York, New York, and Chicago, Illinois, were recruited to participate in structured, in-person interviews as part of the Asthma Beliefs and Literacy in the Elderly (ABLE) study (n = 425). Behaviors related to medication use were investigated, including adherence to prescribed regimens, metered-dose inhaler (MDI) technique, and dry powder inhaler (DPI) technique. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Cognitive function was assessed in terms of fluid (working memory, processing speed, executive function) and crystallized (verbal) ability.

RESULTS:

The mean age of participants was 68 years; 40% were Hispanic and 30% non-Hispanic black. More than one-third (38%) were adherent to their controller medication, 53% demonstrated proper DPI technique, and 38% demonstrated correct MDI technique. In multivariable analyses, limited literacy was associated with poorer adherence to controller medication (OR, 2.3; 95% CI, 1.29-4.08) and incorrect DPI (OR, 3.51; 95% CI, 1.81-6.83) and MDI (OR, 1.64; 95% CI, 1.01-2.65) techniques. Fluid and crystallized abilities were independently associated with medication behaviors. However, when fluid abilities were added to the model, literacy associations were reduced.

CONCLUSIONS:

Among older patients with asthma, interventions to promote proper medication use should simplify tasks and patient roles to overcome cognitive load and suboptimal performance in self-care.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Qualitative_research Limite: Aged / Female / Humans / Male Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Qualitative_research Limite: Aged / Female / Humans / Male Idioma: En Ano de publicação: 2015 Tipo de documento: Article