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Health Literacy among Swedish Patients in Opioid Substitution Treatment : A Mixed-Methods Study

Dahlman, Disa LU ; Ekefäll, Malin and Garpenhag, Lars LU (2020) In Drug and Alcohol Dependence 214.
Abstract

Background: Poor health and unmet healthcare needs is common among people with substance use disorder (SUD) including patients in opioid substitution treatment (OST). Low health literacy (HL) is associated with poverty, low education and physical limitations, but is unexplored in an OST context. Methods: Mixed-methods were used. Participants were consecutively recruited by clinic staff or researcher, from five OST clinics in Malmö, Sweden, during September – November 2019. HL level was measured through HLS-EU-Q16 (n?=?286). Self-reported socioeconomic correlates of HL were analyzed through logistic regression. Patients’ experiences of HL-related problems were assessed through six focus group interviews (n?=?23) moderated by an OST... (More)

Background: Poor health and unmet healthcare needs is common among people with substance use disorder (SUD) including patients in opioid substitution treatment (OST). Low health literacy (HL) is associated with poverty, low education and physical limitations, but is unexplored in an OST context. Methods: Mixed-methods were used. Participants were consecutively recruited by clinic staff or researcher, from five OST clinics in Malmö, Sweden, during September – November 2019. HL level was measured through HLS-EU-Q16 (n?=?286). Self-reported socioeconomic correlates of HL were analyzed through logistic regression. Patients’ experiences of HL-related problems were assessed through six focus group interviews (n?=?23) moderated by an OST employee. Results: While 46% had sufficient HL (13–16 points of maximum 16), 32% did not receive a HL score due to too many missing answers. No correlates of sufficient HL level were found. Missing HL level was associated with low educational attainment (Ajusted odds ratio [AOR] 1.94; 95% Confidence interval [CI] 1.13–3.32) and negatively associated with employment (AOR 0.28; 95% CI 0.11–0.71). Qualitative data revealed a diversity in participants’ self-assessed capabilities, and problems associated with access, comprehension, trust and dependency on addiction-specific services. Conclusions: This study highlights that HL level is low, and identifies a number of concrete problems related to HL in the studied population. The results implicate a need for tailored interventions regarding health information among OST patients.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Health Equity, Health Literacy, HLS-EU-Q16, Mixed Methods, Opiate Substitution Treatment, Sweden
in
Drug and Alcohol Dependence
volume
214
article number
108186
publisher
Elsevier
external identifiers
  • scopus:85088627605
  • pmid:32721789
ISSN
0376-8716
DOI
10.1016/j.drugalcdep.2020.108186
language
English
LU publication?
yes
id
d628730c-294d-48e3-bf7a-e90e032305fb
date added to LUP
2020-08-04 09:34:10
date last changed
2024-06-13 20:59:20
@article{d628730c-294d-48e3-bf7a-e90e032305fb,
  abstract     = {{<p>Background: Poor health and unmet healthcare needs is common among people with substance use disorder (SUD) including patients in opioid substitution treatment (OST). Low health literacy (HL) is associated with poverty, low education and physical limitations, but is unexplored in an OST context. Methods: Mixed-methods were used. Participants were consecutively recruited by clinic staff or researcher, from five OST clinics in Malmö, Sweden, during September – November 2019. HL level was measured through HLS-EU-Q16 (n?=?286). Self-reported socioeconomic correlates of HL were analyzed through logistic regression. Patients’ experiences of HL-related problems were assessed through six focus group interviews (n?=?23) moderated by an OST employee. Results: While 46% had sufficient HL (13–16 points of maximum 16), 32% did not receive a HL score due to too many missing answers. No correlates of sufficient HL level were found. Missing HL level was associated with low educational attainment (Ajusted odds ratio [AOR] 1.94; 95% Confidence interval [CI] 1.13–3.32) and negatively associated with employment (AOR 0.28; 95% CI 0.11–0.71). Qualitative data revealed a diversity in participants’ self-assessed capabilities, and problems associated with access, comprehension, trust and dependency on addiction-specific services. Conclusions: This study highlights that HL level is low, and identifies a number of concrete problems related to HL in the studied population. The results implicate a need for tailored interventions regarding health information among OST patients.</p>}},
  author       = {{Dahlman, Disa and Ekefäll, Malin and Garpenhag, Lars}},
  issn         = {{0376-8716}},
  keywords     = {{Health Equity; Health Literacy; HLS-EU-Q16; Mixed Methods; Opiate Substitution Treatment; Sweden}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Drug and Alcohol Dependence}},
  title        = {{Health Literacy among Swedish Patients in Opioid Substitution Treatment : A Mixed-Methods Study}},
  url          = {{http://dx.doi.org/10.1016/j.drugalcdep.2020.108186}},
  doi          = {{10.1016/j.drugalcdep.2020.108186}},
  volume       = {{214}},
  year         = {{2020}},
}