A44-45 Clinic-based, Provider-led Education Dramatically Improves Health Literacy in Chronic Respiratory Failure

Rationale Chronic respiratory failure (CRF) often occurs in the context of advanced chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and neuromuscular disorders- where low health literacy contributes to low adherence, self-management, and poor outcomes. Targeted, clinic-based education may help address this gap. Objectives Evaluate the impact of a structured, provider-led educational intervention delivered during routine clinic visits on patient health literacy, and to assess domain-specific improvements. Methods We conducted a prospective, pre-post quality improvement study at a single academic center. Adults with CRF were assessed using a project-specific, non-validated 12-item Likert questionnaire (score range 12-48) designed to measure disease knowledge, treatment awareness, and self-management confidence. Patients first completed the questionnaire during clinic for baseline measurement. The intervention consisted of directed, provider-led education during the clinic visit, covering inhaler technique, prescribed medications, ventilatory support, and action planning for exacerbations. The same questionnaire was repeated at 3 month interval. The primary outcome was change in total health literacy score; secondary outcomes included item-level improvements and the proportion of patients achieving a clinically meaningful gain (>5 points). Results Among 51 patients with paired data, mean (SD) total score improved from 25.6 (7.4) to 41.3 (6.7), a mean gain of + 15.7 (9.3) (p < 0.001, Cohen’s d = 1.69, large). All 12 items improved, with the largest gains in inhaler technique (+1.43), medication awareness (+1.37), and knowing what to do when breathing worsens (+1.37). Secondary analysis showed that >85% of patients improved by ≥ 5 points. Conclusions A structured, clinic-based, provider-led educational intervention was associated with large and statistically significant improvements in health literacy among patients with CRF. Limitations include the pre-post single-center design without a control group, which limits causal inference and generalizability. Larger controlled studies are warranted to determine whether these literacy gains translate into improved clinical outcomes such as fewer exacerbations, reduced hospitalizations, and enhanced quality of life.