Evidence map›Paper›PMID 26721913›Full record

Trial reportCirculation. Heart failure2016

Health Literacy Mediates the Relationship Between Age and Health Outcomes in Patients With Heart Failure.

Jia-Rong Wu, Debra K Moser, Darren A DeWalt, Mary Kay Rayens, Kathleen Dracup

Registry-linked trialAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation. Heart failure, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00415545 (Improving Self Care Behavior and Outcomes in Rural Patients With Heart Failure), which is not on this map. Cited by 35 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00415545 phase3completednot on this map

Improving Self Care Behavior and Outcomes in Rural Patients With Heart Failure

TypeinterventionalSponsorUniversity of California, San FranciscoRan2007 to 2013Enrolled614ConditionsHeart Failure, CongestiveArmsFluid Watchers LITE Educational Intervention, Fluid Watchers PLUS Educational Intervention
3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  16. Cardiovascular Diseases and Zinc.Biological trace element research · 2023
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jia-Rong WuFrom the School of Nursing (J.-R.W.) and School of Medicine (D.A.D.W.), University of North Carolina at Chapel Hill; University of Kentucky, College of Nursing, Lexington (D.K.M., M.K.R.); University of Ulster, Jordanstown, Northern Ireland (D.K.M.); and School of Nursing, University of California San Francisco (K.D.). jiarongw@email.unc.edu.
Debra K MoserFrom the School of Nursing (J.-R.W.) and School of Medicine (D.A.D.W.), University of North Carolina at Chapel Hill; University of Kentucky, College of Nursing, Lexington (D.K.M., M.K.R.); University of Ulster, Jordanstown, Northern Ireland (D.K.M.); and School of Nursing, University of California San Francisco (K.D.).
Darren A DeWaltFrom the School of Nursing (J.-R.W.) and School of Medicine (D.A.D.W.), University of North Carolina at Chapel Hill; University of Kentucky, College of Nursing, Lexington (D.K.M., M.K.R.); University of Ulster, Jordanstown, Northern Ireland (D.K.M.); and School of Nursing, University of California San Francisco (K.D.).
Mary Kay RayensFrom the School of Nursing (J.-R.W.) and School of Medicine (D.A.D.W.), University of North Carolina at Chapel Hill; University of Kentucky, College of Nursing, Lexington (D.K.M., M.K.R.); University of Ulster, Jordanstown, Northern Ireland (D.K.M.); and School of Nursing, University of California San Francisco (K.D.).
Kathleen DracupFrom the School of Nursing (J.-R.W.) and School of Medicine (D.A.D.W.), University of North Carolina at Chapel Hill; University of Kentucky, College of Nursing, Lexington (D.K.M., M.K.R.); University of Ulster, Jordanstown, Northern Ireland (D.K.M.); and School of Nursing, University of California San Francisco (K.D.).

Funding

Improving Self Care Behavior/Outcomes in Rural PatientsR01HL083176 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DRACUP, KATHLEEN A · 2006 to 2010
$4.0M
Self-Management Pilot/Feasibility and Biobehavioral Outcomes CoreP20NR010679 · NINR · UNIVERSITY OF KENTUCKY · PI LENNIE, TERRY A · 2007 to 2011
$1.2M
A Family-Focused, Literacy-Sensitive Intervention to Improve Medication AdherenceK23NR014489 · NINR · UNIV OF NORTH CAROLINA CHAPEL HILL · PI WU, JIA-RONG · 2013 to 2015
$379k
NHLBI NIH HHS 5R01HL83176-5NHLBI NIH HHS R01 HL083176NINR NIH HHS 1P20NR010679NINR NIH HHS K23 NR014489NINR NIH HHS K23NR014489NINR NIH HHS P20 NR010679
6 · The paper itself

Abstract

backgroundPrevious studies have linked frequent rehospitalizations for heart failure (HF) and increased mortality with older age, higher severity of HF, lack of an evidence-based medication regimen, and inadequate health literacy. However, the pathway between age and health outcomes in patients with HF remains unknown. Therefore, the purpose of this study was to test whether the association between age and health outcomes can be explained by severity of HF, evidence-based medication use, and health literacy in patients with HF. METHODS AND

resultsThis was a longitudinal study of 575 rural patients with HF recruited from outpatient clinics and hospitals. Demographics, clinical data, and health literacy were collected at baseline. HF readmissions and cardiac mortality were followed for 2 years; 57% of patients were ≥ 65 years of age. Older patients with HF were more likely to have low health literacy and less likely to be prescribed angiotensin-converting enzyme inhibitors or β-blockers. Using Kaplan-Meier survival curves with log-rank tests, health outcomes were significantly worse in patients who were ≥ 65 years and in those with low health literacy. Separate Cox regressions revealed that age and health literacy predicted worse health outcomes (P = 0.006 and < 0.001, respectively). When health literacy was entered into the model, the hazard ratio for age changed from 1.49 to 1.29 (a 41% reduction); age was no longer a significant predictor of health outcomes, but health literacy remained significant (P < 0.001), demonstrating mediation.

conclusionsHealth literacy mediates the relationship between age and health outcomes in adults with HF. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00415545.

Indexed as

Health Knowledge, Attitudes, PracticeHealth LiteracyAdrenergic beta-AntagonistsAgedAge FactorsAgingAngiotensin-Converting Enzyme InhibitorsCause of DeathChi-Square DistributionDisease-Free SurvivalFemaleHealthcare DisparitiesHeart FailureHumansKaplan-Meier EstimateLinear ModelsAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme Inhibitorsagingangiotensin-converting enzyme inhibitorshealth literacyheart failurelongitudinal studies

Identifiers

PMID26721913
PMCPMC4698978

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.