Access Type

Open Access Dissertation

Date of Award

January 2011

Degree Type


Degree Name



Curriculum and Instruction

First Advisor

Karen L. Tonso


The role of pharmacists in the U.S. continues to evolve. Pharmacists are now being trained to be drug information specialists and medication counselors. More than ever, pharmacists are helping patients with chronic conditions manage their diseases through the use of medication therapy management programs. As a part of these programs, it is important that pharmacists are aware of what affect their patients' health literacy level may have on health outcomes.

The purpose of this study was to examine the extent to which health literacy was associated with different demographic factors and the extent to which health literacy was associated with clinical outcomes for patients with asthma, diabetes mellitus, cardiovascular disease/hypertension, and depression/anxiety in a well-defined, self-insured university population.

To answer the research question, data from the pharmacist-led program "Medication Therapy Management and Health Literacy Assessment through Health Horizons: Manage My Medications" was analyzed. Data were collected on demographic, psychosocial, and physical functioning using standard assessment instruments and patient interviews. Additionally, certain clinical tests were performed to assess and gain an understanding of the control of patients' disease state(s). Data was collected at two points - upon entering the program and at six months. This study only examined baseline data.

For this study, patients were categorized by having either limited health literacy or adequate health literacy. Of the 90 participants enrolled, 11.11% had limited health literacy; 88.89% demonstrated adequate health literacy. The results revealed that at the p,<0.05 level, men were significantly more likely to have limited health literacy than women (p=0.049). Age was also found to be associated with limited health literacy. When divided in groups <50 years of age and > 50, there was a significant association between limited health literacy and age (p=0.02). When considering years of formal education, patients with lower levels of educational had greater likelihood of having limited health literacy. Among different educational levels, there was a significant association between limited health literacy and education (p=0.024).

When considered individually , limited health literacy was not found to be associated with any clinical outcomes of asthma, diabetes, mellitus, cardiovascular disease/hypertension, and depression/anxiety; higher body mass index (BMI), higher blood pressure, higher fasting blood glucose levels, and dyslipidemia; lower medication adherence; the need for patient education; and sub-optimal medication regimens.

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