RESUMO
BACKGROUND: A patient's health literacy is not routinely assessed during visits with a health care provider. Since low health literacy is a risk factor for poor health outcomes, assessing health literacy should be considered as part of the standard medical workup. OBJECTIVES: To evaluate the health literacy levels and medication adherence of patients treated by pharmacists in both the general medicine and the chronic care clinics at an urban free health clinic. METHODS: Eligible patients from the free health clinic completed the Rapid Estimate of Adult Literacy in Medicine (REALM), a health literacy measurement tool, during their clinic visit in 2011. Medication adherence was self-reported by the patients. RESULTS: A total of 100 patients participated (mean age = 48). The majority of participants were female (56%) and white (55%). Most (64%) of the patients scored at a high school reading level according to REALM. Only 21% of participants read at a seventh- to eighth-grade level. Overall medication adherence rate was 73%. Forgetting to take medication was the most popular reason given for nonadherence. CONCLUSION: Disease state and adherence were significantly related in patients with HIV/AIDS and hypertension. Patient's ethnicity was significantly associated with literacy levels (P < .05). Although patients' literacy levels were not significantly associated with self-reported adherence in this population, availability of a patient's baseline health literacy level as a part of the medical record may help clinicians to individualize their interaction based on the patient's health literacy level in order to achieve better health outcomes, including improved medication adherence, especially for underserved populations.
RESUMO
BACKGROUND: This study was designed to explore patient perceptions of sexually transmitted infection (STI) screening and treatment provided by a pharmacist in an urban free health clinic. With health care reform on the horizon, the role of a pharmacist is quickly evolving, making it necessary for pharmacists to sharpen their clinical skills to accurately serve their patients. One in 4 American adolescents is infected with an STI, placing pharmacists in a position to help decrease STI transmission and complications. METHODS: To assess patient attitudes toward pharmacists as STI providers, a convenience sample of patients who presented to an urban free health clinic in 2009 for STI testing were given a confidential survey of 12 statements relating to STI testing and the acceptability of a pharmacist-provider. RESULTS: Patients expressed overwhelming support of a pharmacist as their STI treatment provider (79.9%). The services they were comfortable with a pharmacist performing included running a urine screen (95.1%), performing a physical examination (81.1%), treating STIs (98.2%), and discussing STI test results (93.9%). Patients also approved of pharmacists working under a collaborative practice agreement with a physician (97.6%). CONCLUSIONS: Acceptance by patients of a pharmacist-provider for STI screening may lead to the adoption of pharmacists as providers in STI screening clinics. This would decrease barriers to treatment (eg, stigma and lack of access), increase accessibility to care, and greatly improve the identification of those infected with STIs, ultimately leading to a decrease in the spread and long-term sequelae of untreated STIs.
