Asthma outcomes are poor among older adults with low health literacy

Alex D. Federman, Michael S. Wolf, Anastasia Sofianou, Rachel O'conor, Melissa Martynenko, Ethan A. Halm, Howard Leventhal, Juan P. Wisnivesky

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective: To examine the association of health literacy (HL) with asthma outcomes among older asthmatics. Methods: The study included adults ages ≥60 with moderate to severe asthma in New York City and Chicago. We assessed asthma control with the Asthma Control Questionnaire (ACQ) and the percent predicted forced expiratory volume at 1s (FEV1) by spirometry, hospitalizations and emergency department (ED) visits in the past 6 months, and quality of life. HL was assessed with the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Multivariate logistic regression models controlled for age, sex, race, income, general health and years with asthma. Results: Among 433 individuals, 36% had low HL, 55% were over age 65, 38% were Hispanic and 22% were black. Poor asthma control was reported by 40% and 32% had FEV1 <70% of predicted; 9% had a hospital stay, 23% had an ED and 38% had poor quality of life. In multivariable analysis, individuals with low HL were more likely to have FEV1 <70% predicted (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.39-3.94, p=0.001), hospitalizations (OR 2.53, 95% CI 1.17-5.49, p=0.02) and ED visits for asthma (OR 1.81, 95% CI 1.05-3.10, p=0.03). There were no differences in self-reported asthma control and quality of life. Conclusions: Low HL is associated with poor asthma control by objective measure, and greater likelihood of ED visits and hospitalization. HL is a modifiable target for interventions to improve asthma outcomes in the elderly.

Original languageEnglish (US)
Pages (from-to)162-167
Number of pages6
JournalJournal of Asthma
Volume51
Issue number2
DOIs
StatePublished - Mar 2014

Fingerprint

Health Literacy
Asthma
Hospital Emergency Service
Forced Expiratory Volume
Hospitalization
Odds Ratio
Quality of Life
Confidence Intervals
Logistic Models
Spirometry
Hispanic Americans
Length of Stay

Keywords

  • Asthma
  • Control
  • Elderly
  • Emergency department
  • Health literacy
  • Hospitalization
  • Outcomes
  • Quality of life

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Immunology and Allergy
  • Pediatrics, Perinatology, and Child Health

Cite this

Federman, A. D., Wolf, M. S., Sofianou, A., O'conor, R., Martynenko, M., Halm, E. A., ... Wisnivesky, J. P. (2014). Asthma outcomes are poor among older adults with low health literacy. Journal of Asthma, 51(2), 162-167. https://doi.org/10.3109/02770903.2013.852202

Asthma outcomes are poor among older adults with low health literacy. / Federman, Alex D.; Wolf, Michael S.; Sofianou, Anastasia; O'conor, Rachel; Martynenko, Melissa; Halm, Ethan A.; Leventhal, Howard; Wisnivesky, Juan P.

In: Journal of Asthma, Vol. 51, No. 2, 03.2014, p. 162-167.

Research output: Contribution to journalArticle

Federman, AD, Wolf, MS, Sofianou, A, O'conor, R, Martynenko, M, Halm, EA, Leventhal, H & Wisnivesky, JP 2014, 'Asthma outcomes are poor among older adults with low health literacy', Journal of Asthma, vol. 51, no. 2, pp. 162-167. https://doi.org/10.3109/02770903.2013.852202
Federman AD, Wolf MS, Sofianou A, O'conor R, Martynenko M, Halm EA et al. Asthma outcomes are poor among older adults with low health literacy. Journal of Asthma. 2014 Mar;51(2):162-167. https://doi.org/10.3109/02770903.2013.852202
Federman, Alex D. ; Wolf, Michael S. ; Sofianou, Anastasia ; O'conor, Rachel ; Martynenko, Melissa ; Halm, Ethan A. ; Leventhal, Howard ; Wisnivesky, Juan P. / Asthma outcomes are poor among older adults with low health literacy. In: Journal of Asthma. 2014 ; Vol. 51, No. 2. pp. 162-167.
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abstract = "Objective: To examine the association of health literacy (HL) with asthma outcomes among older asthmatics. Methods: The study included adults ages ≥60 with moderate to severe asthma in New York City and Chicago. We assessed asthma control with the Asthma Control Questionnaire (ACQ) and the percent predicted forced expiratory volume at 1s (FEV1) by spirometry, hospitalizations and emergency department (ED) visits in the past 6 months, and quality of life. HL was assessed with the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Multivariate logistic regression models controlled for age, sex, race, income, general health and years with asthma. Results: Among 433 individuals, 36{\%} had low HL, 55{\%} were over age 65, 38{\%} were Hispanic and 22{\%} were black. Poor asthma control was reported by 40{\%} and 32{\%} had FEV1 <70{\%} of predicted; 9{\%} had a hospital stay, 23{\%} had an ED and 38{\%} had poor quality of life. In multivariable analysis, individuals with low HL were more likely to have FEV1 <70{\%} predicted (odds ratio [OR] 2.34, 95{\%} confidence interval [CI] 1.39-3.94, p=0.001), hospitalizations (OR 2.53, 95{\%} CI 1.17-5.49, p=0.02) and ED visits for asthma (OR 1.81, 95{\%} CI 1.05-3.10, p=0.03). There were no differences in self-reported asthma control and quality of life. Conclusions: Low HL is associated with poor asthma control by objective measure, and greater likelihood of ED visits and hospitalization. HL is a modifiable target for interventions to improve asthma outcomes in the elderly.",
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N2 - Objective: To examine the association of health literacy (HL) with asthma outcomes among older asthmatics. Methods: The study included adults ages ≥60 with moderate to severe asthma in New York City and Chicago. We assessed asthma control with the Asthma Control Questionnaire (ACQ) and the percent predicted forced expiratory volume at 1s (FEV1) by spirometry, hospitalizations and emergency department (ED) visits in the past 6 months, and quality of life. HL was assessed with the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Multivariate logistic regression models controlled for age, sex, race, income, general health and years with asthma. Results: Among 433 individuals, 36% had low HL, 55% were over age 65, 38% were Hispanic and 22% were black. Poor asthma control was reported by 40% and 32% had FEV1 <70% of predicted; 9% had a hospital stay, 23% had an ED and 38% had poor quality of life. In multivariable analysis, individuals with low HL were more likely to have FEV1 <70% predicted (odds ratio [OR] 2.34, 95% confidence interval [CI] 1.39-3.94, p=0.001), hospitalizations (OR 2.53, 95% CI 1.17-5.49, p=0.02) and ED visits for asthma (OR 1.81, 95% CI 1.05-3.10, p=0.03). There were no differences in self-reported asthma control and quality of life. Conclusions: Low HL is associated with poor asthma control by objective measure, and greater likelihood of ED visits and hospitalization. HL is a modifiable target for interventions to improve asthma outcomes in the elderly.

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