Background
Methods
Recruitment procedure for KAPS
Measures
Domain | Measures within KAPS cohort (self-report) | Example comparative Read codes for use in Electronic Healthcare Records (EHR) analysisa |
---|---|---|
Age
| Yes | Date of birth |
Gender
| Yes | Gender |
Socioeconomic index
| Number of years in full time education | Area level index of deprivation for each GP practice (provided by the Index of Multiple Deprivation, from the Office of National Statistics, UK [28]) |
Ethnicity
| Not recorded | Ethnicity Read codes (e.g. 9i00. White British, 9T1B. South Asian, 13Z69 First Language not English, 9NU.. Need for interpreter) |
Sleep problems
| Jenkins Sleep Questionnaire [29] | Sleep problem consultation Read codes (e.g. Fy0.. Sleep disorders, R0053 Hypersomnia sleep apnoea, 1BX0. - Delayed onset of sleep) |
Mental Health
| SF 36 Mental Component Score [30] | Mental health consultation symptoms and diagnoses (e.g. Eu3.. Mood affective disorders, E1 … Non organic psychosis) |
Mobility
| EQ 5D-5 L Mobility [31] | Measures of mobility and function (e.g. 39... Disability assessment, 39H.. Continence assessment, 395.. Dressing ability) |
Comorbidity
| Presence of other long term medical conditions (e.g. Diabetes, Breathing problems/COPD, Heart problems/High blood pressure, Chronic Fatigue Syndrome/Fibromyalgia, Stress, Anxiety or Depression, or other comorbidity). | |
Social isolation
| Live alone [34] | Social isolation Read codes (e.g. 13HL. Social isolation, 1B1K. Loneliness). |
Employment
| Employment status (working, not working due to health/illness, other, e.g. retired, student, homemaker) | Current employment status (e.g. 13 J7. Unemployed, 9 K8.. Sickness certificate, 13JL. Medical problems at work). |
Consultation/prescription frequency
| Not recorded | Count of consultations and count of prescriptions of the time period of medical record review. |
Statistical analysis
Results
Measure | SILS categorisation (based on the need for help in reading health-related materials) | Total Mean (SD) or % | |
---|---|---|---|
Adequate health literacy - Mean (SD) or %
|
Low health literacy - Mean (SD) or %
| ||
SILS % (n) | 83.9% (n = 1260) | 16.1% (n = 241) | n = 1501 |
Age (years) | 57.8 (15.6) | 59.1 (16.7) | 58.1 (15.8) |
Gender (Female) | 57.8% | 58.5% | 57.9% |
Age left school (years old) | 16.0 (1.2) | 15.3 (1.7)a | 15.9 (1.3) |
Sleep problems | 62.7% | 76.2%a | 64.8% |
Mental component score (SF36) | 44.5 (12.5) | 33.9 (12.5)a | 43.7 (13.2) |
EQ 5D Mobility | 2.1 (1.0) | 2.9 (1.1)a | 2.2 (1.1) |
Comorbidity (KAPS, 3 or more) | 8.4% | 22.8%a | 10.7% |
Live alone (social isolation) | 19.5% | 28.3%a | 20.9% |
Employment (off work due to health reasons) | 8.8% | 29.9%a | 12.2% |
Measure | SILS categorisation (based on the need for help in reading health-related materials) | Total Mean (SD) or % | |
---|---|---|---|
Adequate health literacy - Mean (SD) or %
|
Low health literacy - Mean (SD) or %
| ||
IMD deprivation scorea | 5.94 (3.2) | 5.11 (3.2)b | 5.81 (3.2) |
Monthly consultation frequency | 1.73 (1.3) | 2.39 (1.8)b | 1.84 (1.4) |
Monthly prescription frequency | 5.29 (6.1) | 13.43 (18.9)b | 6.60 (9.9) |
Comorbidity (Charlson index score [32]) | 8.26 (6.3) | 13.34 (8.6)b | 9.08 (6.9) |
Mental health consultation | 23.5% | 40.7%b | 26.2% |
Sleep problem consultation | 7.8% | 18.3%b | 9.4% |
Analysis stages i) and ii): testing the accuracy and validity of derived demographic assessments of health literacy (DAHL) and improvements to the DAHL within the KAPS cohort data
Analysis stagea | Sensitivity (95% CI) | Specificity (95%CI) | PPV (95% CI) | NPV (95% CI) | AUC (95% CI) | OR (95% CI) | Percentage variance (R2 × 100) |
---|---|---|---|---|---|---|---|
Stage i) Application of Cohort DAHL | 36.4% (20.4 to 54.9) | 84.7% (82.7 to 86.5) | 5.2% (3.3 to 8.0) | 98.3% (97.8 to 98.7) | 0.52 (0.48 to 0.56) | 3.16 (1.5 to 6.5) | 1% |
Stage ii) Application of Improved Cohort DAHL | 46.8% (40.2 to 53.7) | 90.3% (88.5 to 92.0) | 48.1% 42.5 to 53.8) | 89.9% (88.6 to 90.9) | 0.69 (0.65 to 0.73) | 8.26 (5.9 to 11.5) | 18.4% |
Stage iv) Application of the GP-HLA | 40.1% (33.9 to 46.6) | 88.6% (86.7 to 90.3) | 40.3% (35.1 to 45.6) | 88.5% (87.4 to 89.5) | 0.64 (0.60 to 0.69) | 5.18 (3.8 to 7.1) | 11.2% |