Journal of General Internal Medicine

, Volume 22, Issue 11, pp 1523–1526

Limited Health Literacy is a Barrier to Medication Reconciliation in Ambulatory Care

  • Stephen D. Persell
  • Chandra Y. Osborn
  • Robert Richard
  • Silvia Skripkauskas
  • Michael S. Wolf
Original Article

Abstract

Background

Limited health literacy may influence patients’ ability to identify medications taken; a serious concern for ambulatory safety and quality.

Objective

To assess the relationship between health literacy, patient recall of antihypertensive medications, and reconciliation between patient self-report and the medical record.

Design

In-person interviews, literacy assessment, medical records abstraction.

Participants

Adults with hypertension at three community health centers.

Measurement

We measured health literacy using the short-form Test of Functional Health Literacy in Adults. Patients were asked about the medications they took for blood pressure. Their responses were compared with the medical record.

Results

Of 119 participants, 37 (31%) had inadequate health literacy. Patients with inadequate health literacy were less able to name any of their antihypertensive medications compared to those with adequate health literacy (40.5% vs 68.3%, p = 0.005). After adjusting for age and income, this difference remained (adjusted odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 1.3–6.7). Agreement between patient reported medications and the medical record was low: 64.9% of patients with inadequate and 37.8% with adequate literacy had no medications common to both lists.

Conclusions

Limited health literacy was associated with a greater number of unreconciled medications. Future studies should investigate how this may impact safety and hypertension control.

KEY WORDS

health literacy medication reconciliation medication adherence hypertension knowledge ambulatory care 

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Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Stephen D. Persell
    • 1
  • Chandra Y. Osborn
    • 1
  • Robert Richard
    • 2
  • Silvia Skripkauskas
    • 1
  • Michael S. Wolf
    • 1
  1. 1.Health Literacy and Learning Program, Division of General Internal Medicine, and Institute for Healthcare Studies, Feinberg School of Medicine,Northwestern UniversityChicagoUSA
  2. 2.Cherry Street Health ServicesGrand RapidsUSA

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