Well-Educated Patients More Likely to Understand, Adhere to HIV Treatment Regimens, Study Says
Patients who are well-educated are more likely to understand and comply with complex HIV treatment regimens than those who have had less formal education, according to a RAND study published in today's issue of the Proceedings of the National Academy of Sciences, the AP/Las Vegas Sun reports. Researchers at RAND, a not-for-profit research institution in Santa Monica, Calif., examined the health of patients with HIV and patients with diabetes, diseases that both "require carefully following directions and consistency in taking tests, keeping appointments and taking medicines" (AP/Las Vegas Sun, 7/22). The researchers examined 2,267 HIV patients and more than 12,000 patients with type 1 diabetes (Reuters Health, 7/22). The researchers found that education made a "dramatic difference" when they related the patients' health status to their education level and was more important in predicting a patient's health status than sex, race, age or income (AP/Las Vegas Sun, 7/22). Education is "not just a factor, it is the factor" in determining how patients handled HIV, James Smith, a senior economist at RAND and co-author of the study, said (Fox, Reuters, 7/22). Among college graduates with HIV, 68% received highly active antiretroviral therapy, and 54% of HIV patients who had dropped out of high school received HAART. Among all study patients taking HAART, 57% of college graduates adhered to the "complex pill-taking routine," while 37% of high school dropouts complied with their regimens. In addition, the effect of the patients' education was "directly reflected" in their reported health status. While 31% of the HIV-positive high school dropouts reported their health status as either fair or poor, only 17.8% of HIV-positive college graduates reported fair or poor health. Researchers found similar results with diabetes patients.
Doctors Should Tailor Treatment Instructions to Patient
Study co-author Dana Goldman, a RAND senior economist, said that "people with advanced education have a proven experience in dealing with detailed and complex chores that have to be done consistently." Goldman added that doctors should "adjust the intensity of their care" based on the education of their patient, "simplify[ing]" instructions and performing an "intensive follow-up" with less-educated patients (AP/Las Vegas Sun, 7/22). Smith added that "spending a little extra time helping patients understand what they need to do and why ... will help them stay on track with their treatments" (Reuters, 7/22). Richard Suzman, associate director at the NIH National Institute on Aging, said that the study's analyses "give us hope that we can define strategies to help improve the health of people with less education" (AP/Las Vegas Sun, 7/22).