Health literacy and the patient with heart failure--implications for patient care and research: a consensus statement of the Heart Failure Society of America.
BACKGROUND
Low health literacy compromises patient safety, quality health care, and desired health outcomes. Specifically, low health literacy is associated with decreased knowledge of one's medical condition, poor medication recall, nonadherence to treatment plans, poor self-care behaviors, compromised physical and mental health, greater risk of hospitalization, and increased mortality.


METHODS
The health literacy literature was reviewed for: definitions, scope, risk factors, assessment, impact on health outcomes (cardiovascular disease and heart failure), and interventions. Implications for future research and for clinical practice to address health literacy in heart failure patients were summarized.


RESULTS
General health literacy principles should be applied to patients with heart failure, similar to others with chronic conditions. Clinicians treating patients with heart failure should address health literacy using five steps: recognize the consequences of low health literacy, screen patients at risk, document literacy levels and learning preferences, and integrate effective strategies to enhance patients' understanding into practice.


CONCLUSIONS
Although the literature specifically addressing low health literacy in patients with heart failure is limited, it is consistent with the larger body of health literacy evidence. Timely recognition of low health literacy combined with tailored interventions should be integrated into clinical practice.
Evangelista
Lorraine S
LS
School of Nursing, University of California-Los Angeles, Los Angeles, California, USA. levangel@ucla.edu <levangel@ucla.edu>
Rasmusson
Kismet D
KD
Laramee
Ann S
AS
Barr
Joan
J
Ammon
Susan E
SE
Dunbar
Sandra
S
Ziesche
Susan
S
Patterson
J Herbert
JH
Yancy
Clyde W
CW
D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000379:methods* / Q000592:standards; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D005791:Patient Care / Q000379:methods* / Q000592:standards; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards; D012955:Societies, Medical / Q000592:standards; D014481:United States