Health literacy interventions among patients with chronic diseases: A meta-analysis of randomized controlled trials

Yingshan Shao; Huaqin Hu; Yaxin Liang; Yangyang Hong; Yiqing Yu; Chenxi Liu; Yihua Xu

doi:10.1016/j.pec.2023.107829

Health literacy interventions among patients with chronic diseases: A meta-analysis of randomized controlled trials

Patient Educ Couns. 2023 Sep:114:107829. doi: 10.1016/j.pec.2023.107829. Epub 2023 Jun 1.

Authors

Yingshan Shao¹, Huaqin Hu¹, Yaxin Liang¹, Yangyang Hong¹, Yiqing Yu¹, Chenxi Liu², Yihua Xu³

Affiliations

¹ School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China.
² School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, China. Electronic address: liu_chenxi@hust.edu.cn.
³ School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, China. Electronic address: xuyihua_6@hotmail.com.

PMID: 37270933
DOI: 10.1016/j.pec.2023.107829

Abstract

Objectives: This study was conducted to determine the effectiveness and impact of health literacy interventions for patients with chronic diseases.

Methods: We searched PubMed, Web of Science, Embase, Scopus, and EBSCO CINAHL from inception through March 2022. Eligible chronic diseases include diabetes, heart disease, cancer, and chronic obstructive pulmonary disease. RCTs were included in eligible studies to assess health literacy and other relevant health outcomes. Two investigators selected studies, extracted data, and assessed the methodological quality of included studies independently.

Results: A total of 18 studies involving 5384 participants were included in the final analysis. The implementation of health literacy interventions exhibited a significant improvement in the health literacy level of individuals diagnosed with chronic diseases (SMD = 0.75, 95% CI = 0.40-1.10). Analysis of heterogeneity sources indicated statistically significant variations in the effects of interventions across different diseases and age groups (P < 0.05). However, no significant impact was observed on patients with chronic obstructive pulmonary disease (COPD), interventions with a follow-up duration exceeding three months, or application-based interventions on the health literacy level of individuals with chronic diseases. Remarkably, our findings revealed that health literacy interventions exerted a positive influence on health status (SMD = 0.74, 95% CI = 0.13-1.34), depression and anxiety (SMD = 0.90, 95% CI = 0.17-1.63), as well as self-efficacy (SMD = 0.28, 95% CI = 0.15-0.41) among patients diagnosed with chronic diseases. Furthermore, a specific analysis was conducted to evaluate the effects of these interventions on hypertension and diabetes control. The results demonstrated that health literacy interventions were more effective in enhancing hypertension control compared to diabetes control.

Conclusion: Health literacy interventions have demonstrated effectiveness in improving the health of patients with chronic diseases. The importance of emphasizing the quality of these interventions cannot be overstated, as factors such as appropriate intervention tools, extended intervention duration, and reliable primary care services play crucial roles in their efficacy.

Keywords: Chronic diseases; Health literacy; Interventions; Meta-analysis; Randomized controlled trials.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Chronic Disease
Health Literacy*
Humans
Pulmonary Disease, Chronic Obstructive* / therapy
Quality of Life
Randomized Controlled Trials as Topic