The impact of low health literacy on surgical practice

Background We sought to determine the prevalence of low health literacy (LHL) among patients in a preoperative clinic, the characteristics associated with LHL, and the association between LHL and adherence to preoperative instructions. Methods We conducted a cohort study and interviewed patients at a VA preoperative clinic. We administered a health literacy test and collected sociodemographic information. When patients returned for their scheduled surgical procedures, adherence to preoperative instructions was assessed. Results Of 332 participants, 12% (n = 40) had LHL. Low health literacy was more prevalent among older adults (more than 65 years) compared with those under age 65. Patients with LHL were more likely to be nonadherent to preoperative medication instructions (odds RATIO = 1.9; 95% confidence interval: 0.8 to 4.8), but this was of borderline statistical significance. Conclusions Low health literacy was common among older patients and appeared to be associated with lower adherence to preoperative medication instructions.