Improving the Quality of Chronic Disease Management for Populations with Low Functional Health Literacy: A Call to Action

Abstract

Successful disease management is predicated on effective, systematic, interactive communication between a population of patients with the targeted disease and the providers and health system with whom they make contact. Despite a large body of literature exploring the key elements of effective physician–patient communication, little attention has been paid to the communication barriers that impede disease management efforts. Communication barriers can be challenging to those who design and implement disease management programs. However, the nature of disease management offers tremendous opportunities to positively impact the health of vulnerable populations, the groups who most frequently struggle with communication barriers. The growing recognition of racial, ethnic, and socioeconomic disparities in health outcomes presents an opportunity for those in the quality improvement movement to reduce these disparities. To do so, we must develop a collaborative model of chronic disease care that includes input from a diverse patient population. We must optimize the health messages we share with these patients, and how we share them, to improve the quality of communication, and thus improve outcomes. This paper will (1) review functional health literacy (FHL), which is one measure of a patient's health communication facilities; (2) develop a framework for the association between FHL and the quality of chronic disease care; (3) explore the model of diabetes mellitus; and (4) describe potential health communication interventions to improve the quality of chronic disease management for patients with low FHL.