title: Limited health literacy is a barrier to medication reconciliation in ambulatory care.
abstract: BACKGROUND
  Limited health literacy may influence patients' ability to identify medications taken; a serious concern for ambulatory safety and quality.
  
  
  OBJECTIVE
  To assess the relationship between health literacy, patient recall of antihypertensive medications, and reconciliation between patient self-report and the medical record.
  
  
  METHODS
  In-person interviews, literacy assessment, medical records abstraction.
  
  
  METHODS
  Adults with hypertension at three community health centers.
  
  
  METHODS
  We measured health literacy using the short-form Test of Functional Health Literacy in Adults. Patients were asked about the medications they took for blood pressure. Their responses were compared with the medical record.
  
  
  RESULTS
  Of 119 participants, 37 (31%) had inadequate health literacy. Patients with inadequate health literacy were less able to name any of their antihypertensive medications compared to those with adequate health literacy (40.5% vs 68.3%, p = 0.005). After adjusting for age and income, this difference remained (adjusted odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 1.3-6.7). Agreement between patient reported medications and the medical record was low: 64.9% of patients with inadequate and 37.8% with adequate literacy had no medications common to both lists.
  
  
  CONCLUSIONS
  Limited health literacy was associated with a greater number of unreconciled medications. Future studies should investigate how this may impact safety and hypertension control.
authors.affiliation: Health Literacy and Learning Program, Division of General Internal Medicine, and Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Persell
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.forename: Robert
authors.initials: R
authors.lastname: Richard
authors.forename: Silvia
authors.initials: S
authors.lastname: Skripkauskas
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003151:Community Health Centers; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010353:Patient Education as Topic