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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Article info
Footnotes
Financial Disclosure: C. Lowry Barnes has the following disclosures to report: Health Trust (Consultant/Advisory Role), Medtronic (Consultant/Advisory Role), Responsive Risk Solutions (Consultant/Advisory Role, Stock Ownership), Conformis (Research Funding), Corin (Research Funding), DJO (Other Compensation), Zimmer (Other Compensation).
Conflict of Interest: None reported.
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