Abstract
Knowledge of the health literacy of the patient population is important in the context of supplying medical information, shared decision making, and improving care and health outcomes. Patients with arterial vascular disease are a large subset of the population visiting the vascular surgeon with specific characteristics that are associated with inadequate health literacy. This is the first large scale cross sectional study providing data about the prevalence of inadequate health literacy in patients with arterial vascular disease. Objective: The aim was to identify the prevalence of inadequate health literacy in patients with arterial vascular disease. This was a cross sectional study. Methods: Patients with arterial vascular disease visiting the outpatient clinic between January 5, 2015 and December 28, 2016, were randomly included and screened for inadequate health literacy with the Newest Vital Sign Dutch (NVS-D), a validated health literacy assessment measure. A score of <4 out of six identified individuals with inadequate health literacy. Age, gender, highest education level, and reason for consultation were also registered. Data analysis was performed using Student's t-test or the Mann–Whitney U test and chi-square test. Logistic regression with backward elimination was applied to identify independent predictors. Results: A total of 202 patients were included. The mean NVS-D score was 1.91 (SD 1.948, median 1). The prevalence of inadequate health literacy was 76.7%. A significantly higher prevalence of inadequate health literacy was found in patients ≥65 years (p < .001) and patients with a lower education level (p < .001). No significant difference was found between female/male patients (p = .056), nor between participants with peripheral arterial occlusive disease and abdominal aortic aneurysm (p = .116). Age (OR 1.060; 95% CI 1.017–1.104; p = .005) and education level (OR 0.164; 95% CI 0.078–0.346; p < .001) were identified as independent predictors of inadequate health literacy. Conclusion: This study shows a prevalence of inadequate health literacy of 76.7% in patients with arterial vascular disease, with a significantly higher prevalence in patients ≥65 years and patients with a lower education level. The high prevalence of inadequate health literacy should be considered when information is provided, and suggests the need to further investigate the best methods to convey medical information to this group of vulnerable patients.