Abstract 16308: Health Illiteracy and Cognitive Dysfunction Are Common in Veterans Presenting With Acute Coronary Syndrome: Insights From the MEDICATION Study
INTRODUCTION: Patient adherence to cardiac medications following acute coronary syndrome (ACS) hospitalization reduces risk of recurrent events. Health illiteracy and cognitive dysfunction can impact a patient’s ability to follow directions and adhere to medication regimens. However, the prevalence of these conditions among ACS patients is unknown.
Methods: We assessed health literacy and cognitive function among participants of a clinical trial that tested the effectiveness of a multifaceted intervention to improve medication adherence in patients hospitalized at 4 VA hospitals with ACS. Of 254 enrolled patients, 250 (98%) completed the Rapid Estimate of Adult Literacy in Medicine (REALM-R) survey, an assessment of patients at risk for poor literacy skills, and the St. Louis University Mental Status Exam (SLUMS), a tool assessing for neurocognitive deficits, at baseline during their ACS hospitalization.
RESULTS: Average age was 64 years and almost all (98%) were males. Co-morbidities were common: coronary artery disease (65%), diabetes (46%), and chronic kidney disease (24%). Based on a REALM-R score of <6, 34% of patients were categorized as at risk for poor health literacy. Using the SLUMS, 15% of patients were categorized as having dementia, and 52% with mild neurocognitive impairment. One-quarter (26%) of the patients were at risk for poor health literacy and had cognitive dysfunction. None of the demographic or clinical factors were associated with these conditions except for patient race.
Conclusions: Risk for poor health literacy and cognitive dysfunction are common in ACS patients. These conditions can impact a patient’s ability to adhere to medication regimens and cannot be identified using common demographic and clinical variables. These findings suggest that efforts to screen for health literacy and cognitive impairment are needed during ACS hospitalization to identify patients who may need assistance with medication taking following ACS discharge.
- © 2013 by American Heart Association, Inc.