News | September 11, 2014

Poor Health Literacy Poses Risks for Pacemaker and Defibrillator Patients

September 11, 2014 — Patients who rely on pacemakers and defibrillators to maintain a normal heart rhythm run the risk of serious health complications if they don’t fully understand how the devices work and what to do when they experience an irregular heartbeat. But a study from Columbia University School of Nursing, published in the Journal of Cardiovascular Nursing, found that 40 percent of patients with these devices had little to no ability to understand information about their cardiac health.

“As a nurse practitioner, I use every patient encounter as an opportunity for education,” said lead author Kathleen Hickey, EdD, ANP-BC, FNP-BC, assistant professor at Columbia Nursing. “Health literacy is a particular concern for patients with pacemakers and defibrillators because these patients need to know how to respond if they get a shock from their device. Even when the device is quiet they often need to know how to manage co-existing health conditions like diabetes, heart failure and high blood pressure.”

Risks can stem from some common misunderstandings between patients and clinicians, Hickey said. A patient might ignore advice to avoid rigorous exercise and then be surprised when experiencing an irregular heartbeat, for example. Or, patients instructed to check their pulse regularly and report any abnormal activity might not understand how to do this or what heart rate is cause for alarm. “It’s not enough just to explain the same thing again in the same way,” she said. “You have to stop to ask more specific questions like what activities they do in a typical day and offer simple instructions so they understand, for example, the appropriate heart rate zone for exercise."

To understand the scope of potential communication problems, Hickey and a team of researchers evaluated the health literacy of 116 patients using a standard measure of reading and math comprehension, the Test of Functional Health Literacy in Adults. The study population was ethnically diverse: 37.1 percent white, 39.7 percent Hispanic and 22.4 percent African-American; 77.4 percent of the population reported finishing high school. The average age of the study population was 68. Evaluations were done in English or Spanish. Almost 30 percent of participants had inadequate health literacy, and an additional 10 percent were marginal.

The study also examined literacy among patients with medical conditions that are common among patients with pacemakers and defibrillators. Individuals with hypertension or high cholesterol were more than twice as likely to have limited health literacy as individuals without those conditions. Diabetics were almost twice as likely to have low health literacy.

“The good news here is that people are living longer with these devices,” Hickey said. “The problem is that co-morbidities like diabetes and hypertension can worsen with age, at the same time that cognitive function declines. This makes it more urgent, and more difficult, to improve health literacy.”

The Centers for Disease Control and Prevention define health literacy as the degree to which an individual has the ability to obtain, communicate and comprehend basic health information and treatments to make appropriate decisions about care. Limited health literacy is associated with poorer health outcomes, higher rates of hospitalizations, increased use of the emergency department, improper use of medications and higher healthcare costs.

The study is titled “Assessing Health Literacy in Urban Patients with Implantable Cardioverter Defibrillators (ICDs) and Pacemakers.” The authors declared no financial or other conflicts of interest.

For more information:

Related Content

Patient Enrollment Completed in U.S. IDE Study of THERMOCOOL SMARTTOUCH SF Catheter
News | Cardiovascular Clinical Studies | March 15, 2018
March 15, 2018 –  Johnson & Johnson Medical Devices Companies announced today that Biosense Webster, Inc., who wo
Lexington Begins HeartSentry Clinical Trial
News | Cardiovascular Clinical Studies | February 20, 2018
February 20, 2018 – Lexington Biosciences, Inc., a development-stage medical device company, announced the commenceme
Endologix Completes Patient Enrollment in the ELEVATE IDE Clinical Study
News | Cardiovascular Clinical Studies | February 06, 2018
February 6, 2018 – Endologix, a developer and marketer of treatments for aortic disorders, announced the completion o
12-Month Results from Veryan Medical's MIMICS-2 IDE Study Presented at LINC
News | Cardiovascular Clinical Studies | February 01, 2018
February 1, 2018 – Thomas Zeller (Bad Krozingen, Germany) presented the 12-month results from Veryan Medical’s MIMICS
LimFlow Completes U.S. Feasibility Study Enrollment, Receives FDA Device Status
News | Cardiovascular Clinical Studies | February 01, 2018
February 1, 2018 –  LimFlow SA, developer of minimally-inv
ESC 2017 late breaking trial hot line study presentations.
News | Cardiovascular Clinical Studies | September 12, 2017
September 12, 2017 – The European Society of Cardiology (ESC) Congress 2017 includes several Hot Line Late-breaking C
U.K., NHS studies, weekend effect, hospital admission, atrial fibrillation, heart failure
News | Cardiovascular Clinical Studies | June 28, 2016
New research shows patients admitted to National Health Service (NHS) hospitals in the United Kingdom for atrial...
stroke risk
News | Cardiovascular Clinical Studies | August 28, 2015
Most people assume strokes only happen to octogenarians, but recent evidence suggests that survivors of childhood can
Overlay Init