Chi-Wei Lin, I-Ting Liu, Ru-Yi Huang, Wei-Chieh Hung, Ching-Jung Ho Health literacy and the care quality of newly diagnosed diabetic patients Chi-Wei Lin, I-Ting Liu, Ru-Yi Huang, Wei-Chieh Hung, Ching-Jung Ho E-Da Hospital/I-Shou University, Taiwan Health Evaluation and Promotion Association

Background Diabetes is one of the important chronic disease in modern society, and the occurrence and prognosis of this disease is considered to be correlated with patients’ health belief and behavior. Since health literacy is defined as “the ability to read, filter and understand health information in order to form sound judgments” by EU, it may also play an important role in the care of diabetic patients.

Insufficient ability for adequate diabetes care2 Diabetes in Taiwan Prevalence: 1 Male 4.7-6.5% Female 5.3-6.6% Insufficient ability for adequate diabetes care2 Lack of knowledge Negative attitude Inappropriate health behavior Chang, C.H., et al., Type 2 diabetes prevalence and incidence among adults in Taiwan during 1999–2004: a national health insurance data set study. Diabetic Medicine, 2010. 27(6): p. 636-643. Ching-I Huang, Huey-Mei Jeng, Der-Chung Shen. Diabetes Knowledge, Attitude, Behavior and Demands in Diabetic Patients Health Promotion & Health Education Journal , 1998(18): p. 25-35.

Research Purpose The health literacy in newly diagnosed diabetes patients in southern Taiwan. Score distribution in Health Care, Disease Prevention, Health Promotion The important attributes affecting health literacy and diabetes care outcome Initial health literacy and the diabetes care outcome

theoretical Framework WHO: Health literacy. The solid facts. Copenhagen, Denmark: WHO Regional Office for Europe, 2013.

Population Type 2 Diabetes patients Adult (>18 y/o) Newly diagnosed (<1 year) No obvious cognitive impairment

Tool

Methods This research collects a newly diagnosed diabetes cohort in a large teaching hospital in Southern Taiwan Evaluating the health literacy status in this population, and analyzing the relationship of the diabetes care outcome to the health literacy.

Results Initial enrolled patients: 78 Included in final analysis: 55 Inadequate (0–25) : 10 (18.2%) Problematic (>25–33) : 21 (38.2%) Sufficient (>33–42) : 10 (18.2%) Excellent (>42–50) : 14 (25.5%)

Demographics in inadequate HL and higher HL participants P value Age 58.6 55.6 0.462 Gender (male/female) 3/7 (0.43) 22/23 (0.96) 0.318 BMI 27.5 26.8 0.579 Multiple Chronic Disease (yes/no) 5/5 (1.00) 19/26 (0.73) 0.220 Marital Status (married/single) 7/3 (2.33) 44/1 (44.00) 0.016* Education (<6 year/high school/college) 6/4/0 11/26/8 0.061

clinical characteristic differences between inadequate HL and higher HL participants P value Glucose AC (mg/dL) 133.2 134.4 0.934 HbA1C (%) 8.6 7.3 0.359 Total Cholesterol (mg/dL) 202.3 203.5 0.956 HDL (mg/dL) 44.6 41.0 LDL(mg/dL) 109.3 108.3 0.943 Proteinuria (yes/no) 5/2 10/15 0.209

attributes of adequately controlled DM patients (HbA1C <7%) in six months OR (95% CI) P value Age (≥65 y/o vs. <65 y/o) 8.13 (0.39-168.43) 0.934 Gender (male vs. female) 0.76 (0.08-6.79) 0.802 BMI (≥27 vs. <27) 1.25 (0.82-1.89) 0.956 Initial HbA1C (≤7% vs. >7%) 17.24 (1.42-209.98) 0.026* Inadequate Health Care HL 27.70 (0.45-1708.60) 0.114 Inadequate Disease Prevention HL 0.001 (0.000-1.023) 0.051 Inadequate Health Promotion HL 418.08 (1.541-113414.1) 0.035*

The relationship between and HL and diabetic care outcome Marital status, education and multiple disease condition is related to inadequate health literacy. Diabetes care outcome (HbA1C) showed no obvious relationship with health literacy. Short investigation period and small numbers of participants may limit the research result to reach statistical significance.