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Mapping and critical review of studies on Health literacy in patients with Type 2 Diabetes mellitus

Grant number: 15/13994-0
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): October 01, 2015
Effective date (End): September 30, 2016
Field of knowledge:Health Sciences - Medicine
Principal researcher:Rachel Riera
Grantee:Ariel Cesar de Carvalho
Home Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil


Health Literacy is defined as the level of capacity of individuals to obtain, process and understand information related to health and services required for taking proper decisions in health. One of the factors that makes relevant to assess the level of health literacy is the fact that patients with greater knowledge are able to have a better understanding of their illness, and thus more appropriately control it. Therefore, mapping studies that assess health literacy among patients with diabetes could provide a global view of this level of literacy, and after that, investigate if it is related to a better glycemic control and lower complication rates. Objectives: Mapping and assessing the evidences on the analysis of Health Literacy in patients with DM. Investigating whether inadequate levels of Health Literacy are related to the occurrence of cardiovascular events and further endocrine-metabolic complications in patients with DM. Seeking evidences that support the measurement of Health Literacy in clinical practice of outpatient follow-up of individuals with DM.METHODS: Study Design: Systematic review of the literature. Local: discipline of Medicine Based on Evidences of Escola Paulista de Medicina, Universidade Federal de São Paulo. Criteria for inclusion of the studies: Types of Study: descriptive primary studies; Analytical primary studies (frequency, prevalence, incidence and ecological); Observational primary studies (cohort studies, case-control studies, series of cases); Primary studies with intervention (clinical tests, experimental single cohort); Secondary studies (systemic revisions, meta-analysis, economic assessments). Investigation on Health Literacy in patients with Type 2 DM. Type of Participants: Adult patients with any type of DM2 that underwent to questionnaire for measurement of Health Literacy. Type of Assessed Intervention: Studies that cover and assess any health literacy tests, including TOHFLA (Test of Functional Health Literacy in Adults), S-TOHFLA (Shortened Version of TOHFLA), NVS (Newest Vital Sign) and REALM (Rapid Estimate of Adult Literacy in Medicine).Search for Studies: systematic and sensitive searches will be performed on electronic databases: Embase (via Elsevier); Lilacs (via BVS); Cochrane Database of Systematic Reviews - CDSR (via Wiley) and Medline (via Pubmed). For Embase, the search strategy will be adapted using EMTREE terms. Selection of studies; Extraction and data collection; Assessment of methodological quality: the studies will be assessed by two independent investigators, and in case of divergence, there will be a third investigator. The included studies will have their data extracted by means of a standardized form with information on methodological characteristics; participants' characteristics; and results of the assessed outcomes. Their quality will be evaluated by means of tools like AMSTAR (Assessing the Methodological Quality of Systematic Reviews), Cochrane's Collaboration 'Risk of Bias', PRISMA and CONSORT. Results review: the results will be presented as narrative, considering the quality of the studies, in order to reach the goals established by the projects.

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