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Literacy and blood pressure--do healthcare systems influence this relationship? A cross-sectional study.

Publication ,  Journal Article
Powers, BJ; Olsen, MK; Oddone, EZ; Thorpe, CT; Bosworth, HB
Published in: BMC Health Serv Res
October 23, 2008

BACKGROUND: Limited literacy is common among patients with chronic conditions and is associated with poor health outcomes. We sought to determine the association between literacy and blood pressure in primary care patients with hypertension and to determine if this relationship was consistent across distinct systems of healthcare delivery. METHODS: We conducted a cross-sectional study of 1224 patients with hypertension utilizing baseline data from two separate, but similar randomized controlled trials. Patients were enrolled from primary care clinics in the Veterans Affairs healthcare system (VAHS) and a university healthcare system (UHS) in Durham, North Carolina. We compared the association between literacy and the primary outcome systolic blood pressure (SBP) and secondary outcomes of diastolic blood pressure (DBP) and blood pressure (BP) control across the two different healthcare systems. RESULTS: Patients who read below a 9th grade level comprised 38.4% of patients in the VAHS and 27.5% of the patients in the UHS. There was a significant interaction between literacy and healthcare system for SBP. In adjusted analyses, SBP for patients with limited literacy was 1.2 mmHg lower than patients with adequate literacy in the VAHS (95% CI, -4.8 to 2.3), but 6.1 mmHg higher than patients with adequate literacy in the UHS (95% CI, 2.1 to 10.1); (p = 0.003 for test of interaction). This literacy by healthcare system interaction was not statistically significant for DBP or BP control. CONCLUSION: The relationship between patient literacy and systolic blood pressure varied significantly across different models of healthcare delivery. The attributes of the healthcare delivery system may influence the relationship between literacy and health outcomes.

Duke Scholars

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

October 23, 2008

Volume

8

Start / End Page

219

Location

England

Related Subject Headings

  • Young Adult
  • United States Department of Veterans Affairs
  • United States
  • Randomized Controlled Trials as Topic
  • North Carolina
  • Middle Aged
  • Male
  • Linear Models
  • Hypertension
  • Humans
 

Citation

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Powers, B. J., Olsen, M. K., Oddone, E. Z., Thorpe, C. T., & Bosworth, H. B. (2008). Literacy and blood pressure--do healthcare systems influence this relationship? A cross-sectional study. BMC Health Serv Res, 8, 219. https://doi.org/10.1186/1472-6963-8-219
Powers, Benjamin J., Maren K. Olsen, Eugene Z. Oddone, Carolyn T. Thorpe, and Hayden B. Bosworth. “Literacy and blood pressure--do healthcare systems influence this relationship? A cross-sectional study.BMC Health Serv Res 8 (October 23, 2008): 219. https://doi.org/10.1186/1472-6963-8-219.
Powers BJ, Olsen MK, Oddone EZ, Thorpe CT, Bosworth HB. Literacy and blood pressure--do healthcare systems influence this relationship? A cross-sectional study. BMC Health Serv Res. 2008 Oct 23;8:219.
Powers, Benjamin J., et al. “Literacy and blood pressure--do healthcare systems influence this relationship? A cross-sectional study.BMC Health Serv Res, vol. 8, Oct. 2008, p. 219. Pubmed, doi:10.1186/1472-6963-8-219.
Powers BJ, Olsen MK, Oddone EZ, Thorpe CT, Bosworth HB. Literacy and blood pressure--do healthcare systems influence this relationship? A cross-sectional study. BMC Health Serv Res. 2008 Oct 23;8:219.
Journal cover image

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

October 23, 2008

Volume

8

Start / End Page

219

Location

England

Related Subject Headings

  • Young Adult
  • United States Department of Veterans Affairs
  • United States
  • Randomized Controlled Trials as Topic
  • North Carolina
  • Middle Aged
  • Male
  • Linear Models
  • Hypertension
  • Humans