0
Editor's Correspondence |

Who Actually Has the "Low Health Literacy"?—Reply

Dean Schillinger, MD; Clifford Wilson, BA; Andrew Bindman, MD
Arch Intern Med. 2003;163(14):1745-1746. doi:10.1001/archinte.163.14.1745-a.
Text Size: A A A
Published online

Extract

In reply

McCormick and Jain suggest that one reason that physicians do not meet ADA guidelines is that they are poorly informed about these guidelines. Whether variation in the extent to which patients receive guideline-based care is a consequence of physicians' knowledge, beliefs, and attitudes about the guidelines vs patients' interest in adhering to the recommendations in the guidelines is an empirical question. Our study1 suggests that some of this variation can be explained by the extent to which physicians and patients are truly engaging in a partnership that allows for a mutual exchange of opinions, ideas, and solutions. We also suspect that a frequently unmeasured determinant of quality of care, the system of care itself, may influence the degree to which guideline-based care is delivered. Multidisciplinary care teams, computerized reminder systems, and other disease management interventions have the potential to lower barriers to both physician and patient "adherence" by identifying those in need, enabling timely interventions, addressing comorbidities, supporting decision making, and promoting interactive communication. Only a minority of clinical practices use such strategies2 and these tend not to serve patients most likely to have inadequate functional health literacy. We believe that for significant gains to be made in diabetes care, the chronic care model needs to expand both in its scope and in the extent to which it engages patients with inadequate functional health literacy.3

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com
brightcove.createExperiences();