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Patient Health Literacy and Diabetic Foot Amputations

  • Kristie Hadden
    Correspondence
    Address correspondence to: Kristie Hadden, PhD, Center for Health Literacy, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #599A, Little Rock, AR 72205-7199.
    Affiliations
    Associate Professor, Center for Health Literacy, University of Arkansas for Medical Sciences, Little Rock, AR
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  • Robert Martin
    Affiliations
    Assistant Professor, Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR

    Surgeon, Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Littler Rock, AR
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  • Latrina Prince
    Affiliations
    Instructor, Center for Health Literacy, University of Arkansas for Medical Sciences, Little Rock, AR
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  • C. Lowry Barnes
    Affiliations
    Surgeon, Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Littler Rock, AR

    Chairman, Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR

    Professor, Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
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      ABSTRACT

      Patient health literacy is associated with self-care and management of chronic diseases, including diabetes. Interventions that address health literacy and aim to improve clinical outcomes have been focused mostly in primary care. The purpose of this study was to explore the association between patient health literacy and diabetic foot amputations in a retrospective cohort analysis in a large orthopaedic practice at an academic medical center. Using data extraction from clinical records, orthopaedic patients who had a diabetic foot amputation or re-amputation in the last 2 years were compared with the general orthopaedic patient population, with patient health literacy screening results as the dependent variable. Results revealed a statistically significant difference in health literacy between the foot amputee group (N = 177) and the general orthopaedic patient group (N = 14,683) (p < .0001). Patients in the foot amputee group were 8.07 times more likely to have inadequate health literacy than patients in the general orthopaedic patient group. Because diabetic amputations are frequently associated with poorly controlled diabetes, these results provide a strong rationale to develop health literacy–based interventions that address diabetes self-management and foot exams in orthopaedic practices to improve clinical outcomes, including amputation prevention.

      Level of Clinical Evidence

      Keywords

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