Abstract 16635: Health Literacy is an Independent Predictor of Physician Distrust
Background: Following hospitalization, patients with cardiovascular disease must adhere to new medication regimens, modify their lifestyles, and communicate with their providers. Health literacy is a measure of an individual’s ability to obtain, process, and understand the health information required to make healthcare decisions and may affect self-care. We evaluated the relationship between health literacy and physician distrust to understand factors affecting the patient-physician relationship.
Methods: Individuals hospitalized with a diagnosis of acute coronary syndrome (ACS) or acute decompensated heart failure (ADHF) were enrolled in a prospective cohort study. Participants completed self-reported demographics and objective health literacy testing (short Test of Functional Health Literacy in Adults, sTOFHLA). Within a week of discharge, patients completed the Wake Forest Physician Trust questionnaire in reference to their recent hospitalization. Based on the distribution of scores, four categories were created: no distrust and mild, moderate, and significant distrust. A multi-variable Poisson regression analysis was applied to assess the relationship between distrust and healthcare literacy after adjusting for covariates.
Results: Among 902 participants, mean age was 60.1 +/- 12.6 years, 54% were male, and 81% Caucasian; 20% had no distrust, 29% mild, 35% moderate, and 16% had significant distrust. In a univariate analysis, physician distrust was associated with age, race, income, low social support, subjective numeracy and objective health literacy (all p<0.05). There was no association found between physician distrust and gender, marital status, or education level. In the multivariate analysis, health literacy maintained a significant relationship with physician distrust with a 27% (95% CI 11-45%) increase in distrust for patients with marginal health literacy compared to those with adequate literacy (p <0.001). An incremental increase in distrust was not noted in the inadequate literacy group.
Conclusion: Individuals with marginal health literacy have higher levels of physician distrust. Additional research is required to understand the implications of increased distrust.
- © 2013 by American Heart Association, Inc.