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

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Health Literacy among Swedish Patients in Opioid Substitution Treatment : A Mixed-Methods Study. / Dahlman, Disa; Ekefäll, Malin; Garpenhag, Lars.

In: Drug and Alcohol Dependence, Vol. 214, 108186, 2020.

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TY - JOUR

T1 - Health Literacy among Swedish Patients in Opioid Substitution Treatment

T2 - A Mixed-Methods Study

AU - Dahlman, Disa

AU - Ekefäll, Malin

AU - Garpenhag, Lars

PY - 2020

Y1 - 2020

N2 - 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.

AB - 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.

KW - Health Equity

KW - Health Literacy

KW - HLS-EU-Q16

KW - Mixed Methods

KW - Opiate Substitution Treatment

KW - Sweden

U2 - 10.1016/j.drugalcdep.2020.108186

DO - 10.1016/j.drugalcdep.2020.108186

M3 - Article

C2 - 32721789

AN - SCOPUS:85088627605

VL - 214

JO - Drug and Alcohol Dependence

JF - Drug and Alcohol Dependence

SN - 1879-0046

M1 - 108186

ER -