Health literacy in younger and in older patients with type 2 diabetes undergoing coronary angiography

Introduction Health literacy reflects the ability to make appropriate health decisions and affects health outcomes. It therefore is an important parameter in patient care. Purpose The purpose of this study was to investigate the health literacy of patients undergoing coronary angiography. Methods We enrolled 697 consecutive patients undergoing coronary angiography for the evaluation of established or suspected stable CAD in a tertiary care setting in central Europe. Health literacy was measured using the validated HLS- EU-Q16 questionnaire. Results A response rate of 79.5% was achieved. Overall, 222 patients (31.9%) had type 2 diabetes (T2DM). The mean age was 67.6±10.9 years, 272 patients were <65 years and 425 patients ≥65 years. Comparing T2DM patients to those who did not have diabetes, overall median health literacy scores (HLS) were 12.0 [IQR:10-15] vs. 13 [IQR:10-15] among patients <65 years (p=0.655) and 12 [IQR:10-16] vs. 13 [IQR:11-15] among older patients ≥65 years (p=0.856). Prevalence rates of adequate (HLS 13-16), problematic (HLS 9-12) and inadequate (HLS 0-8) health literacy did not differ significantly in patients with T2DM vs. subjects without T2DM in both age groups: 49.2% vs. 56.1%, 34.4% vs. 27.8% and 16.4% vs. 16.1% among patients <65 years and 49.5% vs. 56.4%, 36.0% vs. 30.7% and 14.4% vs. 12.9% among patients ≥65 years, respectively. Conclusion We conclude that among patients undergoing coronary angiography for the evaluation of established or suspected stable CAD health literacy is suboptimal, regardless of diabetes status and age.