| Author | Martins, Maria Auxiliadora Parreiras | |
| Author | Costa, Josiane Moreira | |
| Author | Mambrini, Juliana Vaz de Melo | |
| Author | Ribeiro, Antonio Luiz Pinho | |
| Author | Benjamin, Emelia J. | |
| Author | Brant, Luisa Campos Caldeira | |
| Author | Paasche-Orlow, Michael K. | |
| Author | Magnani, Jared W. | |
| Access date | 2018-10-09T18:42:26Z | |
| Available date | 2018-10-09T18:42:26Z | |
| Document date | 2017 | |
| Citation | MARTINS, Maria Auxiliadora Parreiras et al. Health literacy and warfarin therapy at two anticoagulation clinics in Brazil. Heart, v. 103, n. 14, p. 1089-1095, 2017. | pt_BR |
| ISSN | 1355-6037 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/29480 | |
| Language | eng | pt_BR |
| Publisher | BMJ Pub. Group | pt_BR |
| Rights | open access | pt_BR |
| Subject in Portuguese | Anticoagulantes | pt_BR |
| Subject in Portuguese | Alfabetização em saúde | pt_BR |
| Subject in Portuguese | Serviços de saúde | pt_BR |
| Subject in Portuguese | Doenças cardíacas | pt_BR |
| Subject in Portuguese | Hospitais de ensino | pt_BR |
| Subject in Portuguese | Varfarina | pt_BR |
| Title | Health literacy and warfarin therapy at two anticoagulation clinics in Brazil | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1136/heartjnl-2016-310699 | |
| Abstract | OBJECTIVE: Health literacy has been related to health-related conditions and health outcomes. Studies examining the association of health literacy and anticoagulation have had variable results. We sought to investigate the relations of health literacy and percentage of time in therapeutic range (TTR) in a vulnerable Brazilian cohort at two hospital-based anticoagulation clinics.
METHODS: We measured health literacy with the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18) in 2015-2016. We identified the demographic and clinical characteristics associated with health literacy and related health literacy to TTR.
RESULTS: We enrolled 422 adults prescribed chronic warfarin therapy in our observational study (median age 62.1 years; 58.8% women; monthly income $200.00). The prevalence of inadequate health literacy (score 0-14 points) was 72.3% with a median score of 12 (quartiles, Q1=10; Q3=15) on the SAHLPA-18. The median TTR was 66.1%. In the multivariable logistic analysis, cognitive impairment and assistance with taking warfarin were associated with inadequate health literacy. Prosthetic heart valves and more school years were associated with adequate health literacy. Our analyses showed no significant relation between health literacy and TTR, analysing health literacy as a categorical (adjusted OR 1.05; 95% CI 0.65 to 1.70) or continuous variable (Spearman's coefficient 0.02; p=0.70).
CONCLUSIONS: Inadequate health literacy was highly prevalent in this impoverished Brazilian cohort receiving anticoagulation with warfarin. However, we did not identify an association between health literacy and TTR. Future investigations may consider the systemic factors that contribute towards successful anticoagulation outcomes for vulnerable patient cohorts with inadequate health literacy. | pt_BR |
| Affilliation | Universidade Federal de Minas Gerais. Hospital das Clínicas e Faculdade de Farmácia. Belo Horizonte, MG, Brazil / Sections of Cardiovascular Medicine and Preventive Medicine. Boston Medical Center. Boston University School of Medicine. Boston, Massachusetts, USA | pt_BR |
| Affilliation | Hospital Risoleta Tolentino Neves. Belo Horizonte, MG, Brazil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brazil. | pt_BR |
| Affilliation | Universidade Federal de Minas Gerais. Faculdade de Medicina. Hospital das Clínicas. Belo Horizonte, MG, Brazil. | pt_BR |
| Affilliation | Boston University and National Heart, Lung, and Blood Institute’s Framingham Heart Study. Framingham, Massachusetts, USA / Sections of Cardiovascular Medicine and Preventive Medicine. Boston Medical Center. Boston University School of Medicine. Boston, Massachusetts, USA/Department of Epidemiology. Boston University School of Public Health. Boston, Massachusetts, USA. | pt_BR |
| Affilliation | Universidade Federal de Minas Gerais. Faculdade de Medicina. Hospital das Clínicas. Belo Horizonte, MG, Brazil. | pt_BR |
| Affilliation | General Internal Medicine. Boston University School of Medicine. Boston, Massachusetts, USA. | pt_BR |
| Affilliation | Department of Medicine. Division of Cardiology. UPMC Heart and Vascular Institute. University of Pittsburgh. Pittsburgh, Pennsylvania, USA. | pt_BR |
| Subject | Anticoagulants | pt_BR |
| Subject | Health Literacy | pt_BR |
| Subject | Health Services | pt_BR |
| Subject | Heart Diseases | pt_BR |
| Subject | Teaching Hospitals | pt_BR |
| Subject | Warfarin | pt_BR |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
| xmlui.metadata.dc.subject.ods | 04 Educação de qualidade | |
