The Effect of a Multimodal Educational Intervention on Health Literacy in Patients with Ischemic Heart Diseases

Studies investigated the relationship between Health Literacy (HL) and quality of life, medication adherence, and frequency of hospitalization. However, few studies are available on the effects of patient education strategies on the HL of patients with ischemic heart disease (IHD). We investigated the effect of a multimodal educational intervention on HL in patients with IHD.  This quasi-experimental study was conducted on 50 patients with IHD referred to Shahid Beheshti Hospital in Kashan, Iran, from February to September 2020. Patients were consecutively selected and randomly divided into two groups that either received a multimodal HL intervention or were treated as usual. The multimodal HL intervention included an educational booklet, two individual face-to-face training sessions, and enrolling in one of the groups created in WhatsApp and Telegram messengers. Patients were assessed at baseline and at the end of the eighth week using the HL questionnaire for patients with cardiac diseases. Data were analyzed by the Kolmogorov-Smirnov, independent-samples t, paired-samples t, Chi-square and Fisher's exact tests, and analysis of covariance. The mean HL scores of the intervention and control groups did not differ significantly at baseline. At the end of the study, the mean HL score in the intervention group increased by 98.12 points to reach 169.04±8.36, whereas in the control group it increased by only 10.32 points to reach 84.12±12.21. The mean scores of the two groups were significantly different at the end of the study (P< 0.001). After the intervention, the mean HL score in the intervention group increased 2.4 times, whereas the mean score of the control group changed slightly. Nurses and physicians are recommended to use additional modalities, such as digital social networks, in addition to in-person education to strengthen their interactions with their IHD patients and improve patient HL.