Key result
Patients with heart failure average moderate health literacy with lowest scores in critical literacy.
Why the study?
Limited health literacy impairs disease understanding, self-care, treatment adherence, and quality of life in HF while increasing healthcare utilization and hospital readmissions, making it a critical policy priority for improving patient outcomes.
Cross-Sectional (n=385)
No
Answers are grounded in this paper and cite their sources.
This policy brief and cross-sectional study highlights suboptimal critical health literacy among Iranian patients with heart failure and proposes a staged national policy framework to integrate health literacy screening and education into routine cardiac care.
Health literacy is a critical determinant of effective heart failure (HF) management and an essential policy priority for improving patient outcomes. Limited health literacy impairs disease understanding, self-care, treatment adherence, and quality of life while increasing healthcare utilization and hospital readmissions. This policy brief is informed by findings from a cross-sectional study of 385 patients with heart failure in northwest Iran. Health literacy was assessed using the Functional, Communicative, and Critical Health Literacy (FCCHL) scale. Descriptive statistics and Pearson correlation analyses were performed to examine health literacy levels and their associations with key patient outcomes. The findings identified substantial deficiencies in health literacy among patients with heart failure, highlighting significant barriers to effective disease management and implementation of evidence-based cardiac care policies. Lower health literacy was associated with poorer self-care, reduced treatment adherence, and less favorable health outcomes, emphasizing the need for health literacy-responsive healthcare systems. Implications for Policy: Strengthening health literacy should be a national policy priority in heart failure care. Integrating structured health literacy interventions into routine clinical practice, implementing targeted patient education, and addressing social determinants of health can improve self-care, medication adherence, health equity, and quality of life. Evidence from the Heart and Stroke Foundation of Canada indicates that post-discharge health literacy education clinics reduced hospital readmissions by 22%. Policy implementation should be accompanied by measurable indicators, including a 15% reduction in readmission rates within 12 months, improved medication adherence assessed using the Medication Adherence Report Scale (MARS), and periodic evaluation of patient health literacy using the FCCHL instrument. Immediate integration of health literacy into cardiac care frameworks is essential to reduce disparities and improve cardiovascular outcomes.
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Arash Ziapour (2026) conducted a cross-sectional in Heart failure (LVEF <40%, functional class II-IV) (n=385). Health literacy assessed via the Functional, Communicative, and Critical Health Literacy (FCCHL) scale was evaluated on Total health literacy score on the 12-item Functional, Communicative, and Critical Health Literacy (FCCHL) scale (possible score 12-48). Health literacy among 385 Iranian patients with heart failure had a mean FCCHL score of 38.74±5.9 (out of 48), with the lowest score in critical health literacy (11.55±2.6).
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