Barriers And Interventions Practice Test

A 59-year-old man (weight 101 kg) with type 2 diabetes mellitus and hypertension is prescribed a fixed-dose combination tablet but refuses because he thinks “more medicines means my disease is worse.” Current medications: metformin 1000 mg twice daily (adherent), lisinopril 20 mg daily (adherent), and newly prescribed lisinopril/hydrochlorothiazide 20/12.5 mg daily (not started). Labs: hemoglobin A1c 7.5%, serum creatinine 1.0 mg/dL, potassium 4.3 mEq/L. Social history: limited health literacy; worries about stigma; finances stable. Allergies: none. Which strategy best addresses this patient's health literacy issue?

A 58-year-old man (92 kg) with type 2 diabetes and hypertension presents for medication therapy management; he admits he has been taking metformin immediate-release 1000 mg twice daily only "when he eats a big meal" because he thought it was optional, and he often skips insulin glargine 20 units nightly because he is afraid it will cause immediate blindness. Current medications: metformin immediate-release 1000 mg twice daily (inconsistent), insulin glargine 20 units subcutaneously nightly (missed 3–4 nights/week), lisinopril 20 mg daily (adherent), atorvastatin 40 mg nightly (adherent). Labs: hemoglobin A1c 10.2%, serum creatinine 0.9 mg/dL, alanine aminotransferase 22 U/L; no known drug allergies. He has reliable transportation and insurance but reads at a 5th-grade level and says medication labels are confusing. Which strategy best addresses this patient's health literacy issue?