Section of Pharmacy Practice, University College of Pharmacy, University of the Punjab, Lahore, Pakistan.
Section of Pharmacy Practice, University College of Pharmacy, University of the Punjab, Lahore, Pakistan.
Public Health. 2018 Mar;156:8-14. doi: 10.1016/j.puhe.2017.12.005. Epub 2018 Jan 30.
To evaluate the functional health literacy of patients with type 2 diabetes in Lahore and its impact on glycaemic control.
A six-month cross-sectional study.
Health literacy in 204 patients with diabetes was evaluated using a validated questionnaire (Short Test of Functional Health Literacy [s-TOFHLA]).
The frequency distribution among various age groups (P = 0.003), education levels (P = 0.0005), socio-economic status levels (P = 0.0005) and glycated haemoglobin (HbA) levels (P = 0.0005) differed significantly with health literacy level. The majority of patients with diabetes (86.1%) with poor glycaemic control (HbA >9%) had inadequate health literacy and were more likely to have retinopathy (odds ratio = 13.1, P = 0.003). Health literacy levels were not significantly different when compared for antidiabetic therapies (P = 0.234). Significant associations were observed between predictors of glycaemic control (s-TOFHLA score [P = 0.0005], education status [P = 0.0005] and disease risks [P = 0.005]) and HbA level. However, after adjusting for basic characteristics, only s-TOFHLA score had a significant association with HbA level (P = 0.001).
These data suggest that inadequate health literacy is potentially associated with poor glycaemic control, and microvascular and macrovascular complications, particularly retinopathy. As such, educational and training programmes should be introduced to improve functional health literacy of patients with diabetes for better glycaemic control.
评估拉合尔 2 型糖尿病患者的功能性健康素养及其对血糖控制的影响。
一项为期 6 个月的横断面研究。
使用经过验证的问卷（简短功能性健康素养测试 [s-TOFHLA]）评估 204 例糖尿病患者的健康素养。
各年龄组（P=0.003）、教育水平（P=0.0005）、社会经济地位水平（P=0.0005）和糖化血红蛋白（HbA）水平（P=0.0005）的频率分布与健康素养水平差异有统计学意义。大多数血糖控制不佳（HbA＞9%）的糖尿病患者（86.1%）健康素养不足，且更有可能患有视网膜病变（比值比=13.1，P=0.003）。比较不同的降糖治疗方案时，健康素养水平无显著差异（P=0.234）。血糖控制的预测因素（s-TOFHLA 评分 [P=0.0005]、教育程度 [P=0.0005] 和疾病风险 [P=0.005]）与 HbA 水平之间存在显著相关性。然而，在调整基本特征后，只有 s-TOFHLA 评分与 HbA 水平有显著相关性（P=0.001）。
这些数据表明，健康素养不足可能与血糖控制不佳以及微血管和大血管并发症（特别是视网膜病变）有关。因此，应引入教育和培训计划，以提高糖尿病患者的功能性健康素养，从而更好地控制血糖。
