title: The influence of health literacy level on an educational intervention to improve glaucoma medication adherence.
abstract: OBJECTIVE
  To test an educational intervention targeted to health literacy level with the goal of improving glaucoma medication adherence.
  
  
  METHODS
  One hundred and twenty-seven veterans with glaucoma were randomized to glaucoma education or standard care. The intervention included a video scripted at a 4th, 7th, or 10th grade level, depending on the subject's literacy level. After six months, the number of days without glaucoma medicine (DWM) according to pharmacy records for the intervention and control groups was compared.
  
  
  RESULTS
  The number of DWM in the six months following enrollment was similar for control and intervention groups (intervention, n=67, DWM=63 ± 198; standard care, n=60, DWM=65 ± 198; p=0.708). For each subgroup of literacy (adequate, marginal, inadequate), subjects in the intervention group experienced less mean DWM than subjects in the control group and the effect size (ES) increased as literacy decreased: adequate literacy, ES 0.069; marginal, ES 0.183, inadequate, ES 0.363. Decreasing health literacy skills were associated with decreasing self-reported satisfaction with care (slope=0.017, SE=0.005, p=0.002).
  
  
  CONCLUSIONS
  Patients with decreased health literacy skills may benefit from educational efforts tailored to address their health literacy level and learning style.
  
  
  CONCLUSIONS
  Providers should consider health literacy skills when engaging in glaucoma education.
authors: Duke University Eye Center, Durham, USA. kelly.muir@duke.edu
authors: Kelly W
authors: KW
authors: Muir
authors: Alice
authors: A
authors: Ventura
authors: Sandra S
authors: SS
authors: Stinnett
authors: Abraham
authors: A
authors: Enfiedjian
authors: R Rand
authors: RR
authors: Allingham
authors: Paul P
authors: PP
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006306:Health Surveys; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009657:North Carolina; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D013637:Tape Recording; D014728:Veterans
chemical_list: D004364:Pharmaceutical Preparations