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Relation between health literacy, self-care and adherence to treatment with oral anticoagulants in adults: a narrative systematic review.

Cabellos-García, A. C., Martínez-Sabater, A., Castro-Sanchez, E. ORCID: 0000-0002-3351-9496 , Kangasniemi, M., Juárez-Vela, R. & Gea-Caballero, V. (2018). Relation between health literacy, self-care and adherence to treatment with oral anticoagulants in adults: a narrative systematic review.. BMC Public Health, 18(1), 1157. doi: 10.1186/s12889-018-6070-9


BACKGROUND: Oral anticoagulants (OAC) are widely used in patients with cardiovascular diseases. However, for optimal OAC self-care patients must have skills, among which health literacy (HL) is highlighted. We aimed to describe the relation between HL and self-care in cardiovascular patients on OAC treatment. METHODS: Electronic searches were carried out in the PubMed, Scopus, Embase, CINAHL, Web of Science, Cochrane Library, SciELO, IME-Biomedicina, CUIDEN Plus and LILACS databases, limited to Spanish and English language and between January 2000-December 2016. Papers reported on adults older than 18 years, taking OAC by themselves for at least three months. PRISMA guidelines were used for paper selection. RESULTS: We identified 142 articles and finally included 10; almost all of them about warfarin. Our results suggest that in patients taking OAC treatments there is a positive relationship between HL and the level of knowledge. In addition, a small percentage of participants on the selected papers recognized the side effects and complications associated with OAC treatment. Lower HL level was associated with greater knowledge deficits and less adherence to treatment. CONCLUSION: There is a paucity of research evaluating the effect of HL on diverse aspects of OAC treatments. There is a need to expand the evidence base regarding appropriate HL screening tools, determinants of adequate knowledge and optimal behaviours related to OAC self-management.

Publication Type: Article
Additional Information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Publisher Keywords: Health literacy; Oral coagulation therapy; Self-management; Self-care; Adherence; Systematic review
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Departments: School of Health & Psychological Sciences > Nursing
Text - Published Version
Available under License Creative Commons Attribution.

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