In:
Journal of the American Geriatrics Society, Wiley, Vol. 62, No. 5 ( 2014-05), p. 872-879
Abstract:
To examine self‐management behaviors, including medication adherence and inhaler technique, in older adults with asthma and their association with health literacy. Design Observational cohort study. Setting Primary care and pulmonary specialty practices in two tertiary academic medical centers and three f ederally q ualified h ealth c enters in N ew Y ork, N ew Y ork, and C hicago, I llinois. Participants Adults with moderate or severe persistent asthma aged 60 and older ( N = 433). Measurements Outcomes were adherence to asthma controller medications, metered dose inhaler ( MDI ) and dry powder inhaler ( DPI ) techniques, having a usual asthma physician, and avoidance of four common triggers. Health literacy was assessed using the S hort T est of F unctional H ealth L iteracy in A dults. Results The mean age was 67, and 36% of participants had marginal or low health literacy. Adherence was low (38%) overall and worse in individuals with low health literacy (22%) than in those with adequate literacy (47%, P 〈 .001) and after adjusting for demographic factors and health status (odds ratio (OR) = 0.48, 95% confidence interval ( CI ) = 0.31–0.73). Similarly, inhaler technique was poor; only 38% and 54% had good MDI and DPI technique, respectively. Technique was worse in those with low health literacy ( MDI technique: OR = 0.57, 95% CI = 0.38–0.85; DPI technique: OR = 0.42, 95% CI = 0.25–0.71). Asthma self‐monitoring and avoidance of triggers occurred infrequently but were less consistently associated with low health literacy. Conclusion Adherence to medications and inhaler technique are poor in older adults with asthma and worse in those with low health literacy. Clinicians should routinely assess controller medication adherence and inhaler technique and use low‐literacy communication strategies to support self‐management in older adults with asthma.
Type of Medium:
Online Resource
ISSN:
0002-8614
,
1532-5415
DOI:
10.1111/jgs.2014.62.issue-5
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2040494-3
detail.hit.zdb_id:
80363-7
