Limited health literacy in advanced kidney disease

Dominic M Taylor, John A Bradley, Clare Bradley, Heather Draper, Rachel Johnson, Wendy Metcalfe, Gabriel Oniscu, Matthew Robb, Charles Tomson, Christopher Watson, Rommel Ravanan, Paul Roderick, on behalf of the ATTOM Investigators

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Limited health literacy may reduce the ability of patients with advanced kidney disease to understand their disease and treatment and take part in shared decision making. In dialysis and transplant patients, limited health literacy has been associated with low socioeconomic status, comorbidity, and mortality. Here, we investigated the prevalence and associations of limited health literacy using data from the United Kingdom–wide Access to Transplantation and Transplant Outcome Measures (ATTOM) program. Incident dialysis, incident transplant, and transplant wait-listed patients ages 18 to 75 were recruited from 2011 to 2013 and data were collected from patient questionnaires and case notes. A score >2 in the Single-Item Literacy Screener was used to define limited health literacy. Univariate and multivariate analyses were performed to identify patient factors associated with limited health literacy. We studied 6842 patients, 2621 were incident dialysis, 1959 were wait-listed, and 2262 were incident transplant. Limited health literacy prevalence was 20%, 15%, and 12% in each group, respectively. Limited health literacy was independently associated with low socioeconomic status, poor English fluency, and comorbidity. However, transplant wait-listing, preemptive transplantation, and live-donor transplantation were associated with increasing health literacy.
Original languageEnglish
Pages (from-to)685-695
Number of pages11
JournalKidney International
Issue number3
Early online date10 Aug 2016
Publication statusPublished - Sept 2016

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