Observational studyRespiratory medicine
Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study.
Observational study in Respiratory medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
51 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparative effectiveness of different home-based pulmonary rehabilitation models in patients with COPD: a systematic review and network meta-analysis.NPJ primary care respiratory medicine · 2026Pooled it
- Definitions and measurement of health literacy in health and medicine research: a systematic review.BMJ open · 2022Pooled it
- A Multifaceted Intervention to Improve Patient Knowledge and Safe Use of Opioids: Results of the ED EMCAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2019Trial
- Validation and Reliability Assessment of the Test of Adherence to Inhalers (TAI) in Turkish Patients with Chronic Obstructive Pulmonary Disease (COPD).Thoracic research and practice · 2026Article
- Cognitive impairment in chronic respiratory disease patients using long-term oxygen therapy: a narrative review.Medical gas research · 2026Review
- The Effect of Tele-nursing Education on Medication Adherence and Health Literacy in COPD patients.BMC nursing · 2026Article
- Airway wall thickness and PRISm are associated with cognitive impairment in individuals with cigarette smoking exposure.Respiratory research · 2026Article
- Loneliness in Chronic Obstructive Pulmonary Disease: A Multidimensional Determinant of Clinical Outcomes and Disease Management.Journal of clinical medicine · 2026Review
- The Impact of Care Delivered Through the Self-Management Promotion Model on Health Literacy Levels in Patients With Chronic Obstructive Pulmonary Disease: Quasi-Experimental Research.Health literacy research and practice · 2026Article
- Identification of key influencing factors of health information literacy in COPD patients: a cross-sectional study using a random forest model.BMC pulmonary medicine · 2026Article
- A Conceptual Framework for Individualized Patient Education in Healthcare: A Scoping Review.Patient preference and adherence · 2026Review
- Associations between medication beliefs and medication adherence among inpatients with chronic obstructive pulmonary disease: a cross-sectional survey.Frontiers in public health · 2026Article
- Behavioral Phenotypes of Inhaler Technique and Adherence in COPD: A Cross-Sectional Study.International journal of chronic obstructive pulmonary disease · 2026Article
- Latent classes of self-management and associated factors in patients with COPD.BMC pulmonary medicine · 2025Article
- E-health literacy and attitudes toward internet health information in relation to self-care adherence among Korean patients with chronic obstructive pulmonary disease: a cross-sectional study.BMC public health · 2025Article
- Exploring the Interplay of Health Literacy and Non-Communicable Disease Health Outcomes in Southeast Asia: A Systematic Review.Iranian journal of public health · 2025Review
- An Estimation of the Economic and Environmental Impact of Inhaler Devices Switch for Non-Clinical Reasons in COPD and Asthma: The Case for Spain.Journal of market access & health policy · 2025Article
- Feasibility and acute physiological responses to supramaximal high-intensity interval training in COPD: a randomised crossover trial.ERJ open research · 2025Article
- Validation of the Assessments of Adult Health Literacy: a Rasch measurement model approach.Health promotion international · 2025Article
- Predicting poor self-management behaviors in adults with newly diagnosed COPD: based on the information-motivation-behavioral skills model.BMC public health · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
introductionLow rates of adherence to self-management behaviors are common among patients with COPD. Health literacy and cognitive abilities may influence engagement in self-management behaviors. We sought to assess the association between health literacy and cognitive abilities with self-management behaviors in patients with COPD.
methodsWe conducted an observational cohort study among American adults with COPD in New York, New York, and Chicago, Illinois. Outcomes included adherence to COPD medication, metered dose inhaler (MDI) and dry powder inhaler (DPI) technique, receipt of vaccination, and routine healthcare appointments. Health literacy was measured with the Short Test of Functional Health Literacy in Adults. Cognitive function was assessed in terms of global, fluid (working memory, processing speed, executive function) and crystallized (verbal) ability.
resultsAdequate health literacy was associated with adequate adherence to COPD medications (OR 1.46; 95% CI, 1.02-2.08), correct MDI (OR 1.66; 95% CI, 1.13-2.44) and DPI (OR 2.17; 95% CI, 1.30-3.64) technique. Fluid abilities were also associated with medication behaviors and visiting a regular healthcare provider, while crystalized abilities were not. Global cognitive abilities were associated with correct inhaler technique. No other associations were found with non-medication self-management behaviors.
conclusionsCOPD patients with limited health literacy and deficits in fluid cognitive abilities have lower rates of adherence and poorer inhaler technique than individuals with adequate health literacy and greater fluid cognitive abilities. These findings highlight the importance of considering the health literacy level and cognitive ability when caring for and educating patients with COPD.
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Registered trials
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