Health Literacy and Access to Kidney Transplantation
Open Access
- 1 January 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Journal of the American Society of Nephrology
- Vol. 4 (1), 195-200
- https://doi.org/10.2215/cjn.03290708
Abstract
Background and objectives: Few studies have examined health literacy in patients with end stage kidney disease. We hypothesized that inadequate health literacy in a hemodialysis population is common and is associated with poorer access to kidney transplant wait-lists. Design, setting, participants, & measurements: We enrolled 62 Black and White maintenance hemodialysis patients aged 18 to 75. We measured health literacy using the short form Test of Functional Health Literacy in Adults. Our primary outcomes were (1) time from dialysis start date to referral date for kidney transplant evaluation and (2) time from referral date to date placed on kidney transplant wait-list. We used Cox proportional hazard models to examine the association between health literacy (adequate versus inadequate) and our outcomes after controlling for demographics and co-morbid conditions. Results: Roughly one third (32.3%) of participants had inadequate health literacy. Forty-seven (75.8%) of participants were referred for transplant evaluation. Among those referred, 40 (85.1%) were wait-listed. Participants with inadequate health literacy had 78% lower hazard of referral for transplant evaluation than those with adequate health literacy (adjusted hazard ratio [AHR] 0.22; 95% confidence interval 0.08, 0.60; P = 0.003). The hazard ratio of being wait-listed by health literacy was not statistically different (AHR 0.80, 95% CI, 0.39, 1.61), P = 0.5). Conclusions: Inadequate health literacy is common in our hemodialysis patient population and is associated with a lower hazard of referral for transplant evaluation. Strategies to reduce the impact of health literacy on the kidney transplant process should be explored.Keywords
This publication has 22 references indexed in Scilit:
- Do You Need to Stay in School to Get a Kidney Transplant?American Journal of Kidney Diseases, 2008
- Renal Transplantation in Elderly Patients Older Than 70 Years of Age: Results From the Scientific Registry of Transplant RecipientsTransplantation, 2007
- How health care systems can begin to address the challenge of limited literacyJournal of General Internal Medicine, 2006
- Impact of health literacy on longitudinal asthma outcomesJournal of General Internal Medicine, 2006
- Waiting time on dialysis as the strongest modifiable risk factor for renal transplant outcomesTransplantation, 2002
- Effect of waiting time on renal transplant outcomeKidney International, 2000
- Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric TransplantThe New England Journal of Medicine, 1999
- The Effect of Patients' Preferences on Racial Differences in Access to Renal TransplantationThe New England Journal of Medicine, 1999
- Reading skills and family planning knowledge and practices in a low-income managed-care populationObstetrics & Gynecology, 1999
- Health literacy and the risk of hospital admissionJournal of General Internal Medicine, 1998