Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Health Literacy & Cognitive Abilities in COPD

Respir Med; ePub 2019 Feb 14; O’Conor, et al

Patients with chronic obstructive pulmonary disease (COPD) with limited health literacy and deficits in fluid cognitive abilities have lower rates of adherence and poorer inhaler technique than those with adequate health literacy and greater fluid cognitive abilities. This according to an observational cohort study among American adults with COPD in New York and Chicago. Outcomes included adherence to COPD medication, metered dose inhaler (MDI) and dry powder inhaler (DPI) technique, receipt of vaccination, and routine healthcare appointments. Among the findings:

  • Adequate health literacy was associated with adequate adherence to COPD medications, correct MDI and DPI technique.
  • Fluid abilities were also associated with medication behaviors and visiting a regular healthcare provider, while crystalized abilities were not.
  • Global cognitive abilities were associated with correct inhaler technique.
  • Health literacy and cognitive abilities were not associated with other self-management behaviors such as receipt of vaccines.


O’Conor R, Muellers K, Arvanitis M, et al. Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study. [Published online ahead of print February 14, 2019]. Respir Med. doi:10.1016/j.rmed.2019.02.006.