Empirical research
Patient-Clinician Decision Making for Stable Angina: The Role of Health Literacy
Authors:
Samuel T. Savitz ,
Kaiser Permanente Division of Research, US
Antonia V. Bennett,
University of North Carolina at Chapel Hill, US
Stacy Cooper Bailey,
Northwestern University, US
Stacie B. Dusetzina,
Vanderbilt University Medical Center, US
W. Schuyler Jones,
Duke University Medical Center, US
Sally C. Stearns,
University of North Carolina at Chapel Hill, US
Abstract
Background: Stable angina patients have difficulty understanding the tradeoffs between treatment alternatives. In this analysis, we assessed treatment planning conversations for stable angina to determine whether inadequate health literacy acts as a barrier to communication that may partially explain this difficulty.
Methods: We conducted a descriptive analysis of patient questionnaire data from the PCI Choice Trial. The main outcomes were the responses to the Decisional Conflict Scale and the proportion of correct responses to knowledge questions about stable angina. We also conducted a qualitative analysis on recordings of patient-clinician discussions about treatment planning. The recordings were coded with the OPTION12 instrument for shared decision-making. Two analysts independently assessed the number and types of patient questions and expressions of preferences.
Results: Patient engagement did not differ by health literacy level and was generally low for all patients with respect to OPTION12 scores and the number of questions related to clinical aspects of treatment. Patients with inadequate health literacy had significantly higher decisional conflict. However, the proportion of knowledge questions answered correctly did not differ significantly by health literacy level.
Conclusions: Patients with inadequate health literacy had greater decisional conflict but no difference in knowledge compared to patients with adequate health literacy. Inadequate health literacy may act as a barrier to communication, but gaps were found in patient engagement and knowledge for patients of all health literacy levels. The recorded patient-clinician encounters and the health literacy measure were valuable resources for conducting research on care delivery.
How to Cite:
Savitz ST, Dobler CC, Shah ND, Bennett AV, Bailey SC, Dusetzina SB, et al.. Patient-Clinician Decision Making for Stable Angina: The Role of Health Literacy. eGEMs (Generating Evidence & Methods to improve patient outcomes). 2019;7(1):42. DOI: http://doi.org/10.5334/egems.306
