Using an Intervention Adapted to the Health Literacy Level to Improve Adherence to Medical Recommendations
Using an Intervention Adapted to the Health Literacy Level to Improve Adherence to Medical Recommendations
Health literacy is the ability to access, understand, evaluate and apply information in order
 to communicate with health professionals and understand health instructions but also,
 promote, maintain and improve health throughout life. Health literacy is known as a health
 determinant. Level of Health Literacy (HL) is low or limited within 47% of interrogated
 people in Europe, resulting in an inability to understand and/or use written texts and
 digital concepts about one's health.

 There is a demonstrated link between low HL and low therapeutic adherence, an increase in the
 number of re-admissions, and more generally poor health or survival that is even more
 limited. An association between low LS and higher health care costs has also been reported in
 the USA and Switzerland. WHO highlight the central role of LS in health inequalities,
 regardless of the region of the world.

 We chose to conduct this study in patients hospitalized for an acute cardiovascular event:
 acute myocardial infarction (AMI) or acute decompensated heart failure (ADHF), as these
 patients have cumulative risk factors for misuse and medication errors. They are hospitalized
 in emergency, for shorter and shorter periods and are discharged with complex drug
 treatments. The data show that the return home after acute hospitalization for these
 conditions is a particularly high-risk period for medication errors and misuse, especially
 with low HL. The proportion of patients with preventable ADR in the weeks following their
 return home ranges from 23% to 30% and nearly 60% are re-hospitalized within 6 months.

 Our hypothesis is that in patients hospitalized for AMI or ADHF with low HL levels,
 information on discharge treatment using appropriate tools and techniques will reduce the
 risk of patient-related medication errors or misuse within 30 days of discharge.

 The purpose of this study is to develop an educational intervention model adapted to low HL
 levels and routinely feasible, even in case of short stays, in complementarity with
 traditional therapeutic education programmes that require higher investments and are
 therefore not accessible to all patients. This innovative approach could then be applied to a
 large number of chronic diseases.
Inclusion Criteria:

 -  Inadequate health literacy level according to the Brief Health Literacy Screening
 questionnaire

 -  Age greater than or equal to 18 years

 -  Hospitalization for acute myocardial infarction (myocardial infarction with or without
 ST segment elevation) or acute decompensated heart failure (systolic or diastolic)

 -  Return home after hospitalization

 -  Affiliated with a health insurance plan

 Exclusion Criteria:

 -  Short-term vital prognosis

 -  Bipolar disorders, active psychoses

 -  Severe dementia

 -  Inability to manage drug treatment alone

 -  Institutionalization at the end of hospitalization