International Journal of Cardiovascular Sciences. 14/abr/2025;38:e20240074.

Association Between Functional Health Literacy and the Quality of Oral Anticogulation

Gustavo Chaves de Souza , Josiane Moreira da Costa, Mayara Cristina Oliveira Ortiz , Philipe Dias de Avila Lima , Pollyanna Evelyn de Freitas Nogueira , Carla Jorge Machado, Maria Auxiliadora Parreiras Martins

DOI: 10.36660/ijcs.20240074

Este Artigo Original é referido pelo Editorial "Literacy in Cardiovascular Health: A Strategic Tool in Anticoagulation".

Abstract

Background:

Low functional health literacy in anticoagulated patients using warfarin has been widely discussed in medical literature.

Objective:

To identify the quality of oral anticoagulation (QOA) over time and to analyze the association between this variable and functional health literacy.

Methods:

Prospective cohort study conducted at an anticoagulation clinic (AC) in Minas Gerais, in a high-complexity hospital. The study included 81 patients, whose data were collected by direct consultation of medical records or by asking questions while patients were waiting for care. The QOA was assessed at 6, 9, 12, 15, and 18 months after the beginning of this study, and analyses of the association between this variable and functional health literacy were performed at the different time points. The QOA was identified by calculating the Therapeutic Time Range (TTR), with good quality being obtained with TTR values >59%. The incidence analysis of the TTR was performed for each of the five time points of the study through univariate Poisson regression. The significance level adopted in the statistical analysis was 5%.

Results:

Throughout the study, inadequate control of oral anticoagulation was observed, with only 20% of the patients showing persistent improvement in TTR values. No statistically significant association was identified at the different measurement times between TTR and functional health literacy.

Conclusion:

There was no direct association between the QOA and functional health literacy. However, the low incidence of persistent quality of anticoagulation in patients with low literacy suggests the development of specific educational actions for this subgroup of patients.