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Editor's Correspondence
July 28, 2003

Who Actually Has the "Low Health Literacy"?

Arch Intern Med. 2003;163(14):1745-1746. doi:10.1001/archinte.163.14.1745-a

The article by Schillinger et al,1 "Closing the Loop," addressed the issue of a physician's communication skills and the relationship of these skills to the comprehension of information by diabetic patients ascribed a "low health literacy." Based on current data in terms of diabetic care, the question might be posed as to whether it may be the physician who has the low health literacy. Many physicians fail to follow American Diabetes Association (ADA) guidelines recommended for diabetic care. Some of the more neglected guidelines include an eye examination, controlled low-density lipoprotein cholesterol (<130 mg/dL [3.36 mmol/L]), monitoring of nephropathy, and control of high blood pressure, demonstrated in only 48%, 44%, 41%, and 51% of diabetic patients, respectively, on a nationwide basis.2 Many other typical standards of care were also overlooked, to a lesser extent, in a number of patients. The article by Schillinger et al validates the importance of assessing recall and comprehension of patients in leading to improved glycemic control. However, physicians should assess their own recall of adequate criteria in the management of diabetic care.

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