How do general practitioners manage patient health literacy differences in cardiovascular disease prevention consultations? An interview study

Shannon McKinn; Niamh Chapman; James E Sharman; Rosie Nash; Mark R Nelson; Laura Sutton; Cassia Yung; Jenny Doust; Anna L Hawkes; Carissa Bonner

doi:10.1016/j.pec.2024.108299

How do general practitioners manage patient health literacy differences in cardiovascular disease prevention consultations? An interview study

Patient Educ Couns. 2024 Apr 21:125:108299. doi: 10.1016/j.pec.2024.108299. Online ahead of print.

Authors

Affiliations

¹ Sydney Health Literacy Lab, University of Sydney, Sydney, Australia.
² Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
³ Australian Women and Girls' Health Research (AWaGHR) Centre, University of Queensland, Queensland, Australia.
⁴ School of Public Health, University of Queensland, Queensland, Australia.
⁵ Sydney Health Literacy Lab, University of Sydney, Sydney, Australia; Menzies Centre for Health Policy & Economics, University of Sydney, Sydney, Australia. Electronic address: carissa.bonner@sydney.edu.au.

PMID: 38657560
DOI: 10.1016/j.pec.2024.108299

Abstract

Objectives: Low health literacy is associated with worse health outcomes, including for cardiovascular disease (CVD). However, general practitioners (GPs) have limited support to identify and address patient health literacy needs in CVD prevention consultations. This study explored GPs' experiences of patient health literacy needs during CVD risk assessment and management consultations.

Methods: Semi-structured interviews with 18 GPs in Tasmania, Australia in 2021. A Framework Analysis approach was used to code transcripts to a thematic framework.

Results: GPs perceptions on patient health literacy informed three themes: 1. Methods of estimating health literacy; 2. GPs' perceptions about the impact of health literacy on CVD prevention including risk factor knowledge and behaviours; and 3. Strategies for communicating with patients experiencing health literacy challenges. The findings show that while no formal tools were used to assess health literacy in this sample, perceived health literacy can change GPs' communication and prevention strategies.

Conclusion: The findings raise concerns about the equity of choices made available to patients, based on subjective perceptions of their health literacy level.

Practice implication: GPs could be better supported to assess and address patient health literacy needs in CVD prevention consultations.

Keywords: Cardiovascular Disease; General Practitioner; Patient Health Literacy; Primary Prevention; Risk Assessment; Risk Communication.