Limited health literacy is associated with reduced access to kidney transplantation

被引:75
作者
Taylor, Dominic M. [1 ,2 ]
Bradley, J. Andrew [3 ,4 ]
Bradley, Clare [5 ]
Draper, Heather [6 ]
Dudley, Christopher [2 ]
Fogarty, Damian [7 ]
Fraser, Simon [1 ]
Johnson, Rachel [8 ]
Leydon, Geraldine M. [1 ]
Metcalfe, Wendy [9 ]
Oniscu, Gabriel C. [10 ]
Robb, Matthew [8 ]
Tomson, Charles [11 ]
Watson, Christopher J. E. [3 ,4 ]
Ravanan, Rommel [2 ]
Roderick, Paul [1 ]
机构
[1] Univ Southampton, Acad Unit Primary Care & Populat Sci, Southampton, Hants, England
[2] North Bristol Natl Hlth Serv Trust, Richard Bright Renal Serv, Bristol, Avon, England
[3] Univ Cambridge, Dept Surg, Cambridge, England
[4] Cambridge Biomed Res Ctr, Natl Inst Hlth Res, Cambridge, England
[5] Royal Holloway Univ London, Hlth Psychol Res Unit, London, England
[6] Univ Warwick, Warwick Med Sch, Warwick, England
[7] Belfast Hlth & Social Care Trust, Belfast, Antrim, North Ireland
[8] Natl Hlth Serv Blood & Transplant, Bristol, Avon, England
[9] Scottish Renal Registry, Glasgow, Lanark, Scotland
[10] Royal Infirm Edinburgh NHS Trust, Transplant Unit, Edinburgh, Midlothian, Scotland
[11] Freeman Rd Hosp, Dept Renal Med, Newcastle Upon Tyne, Tyne & Wear, England
关键词
chronic kidney disease; dialysis; health literacy; kidney transplantation; socioeconomic status; INTERVENTIONS; RECIPIENTS; DIALYSIS; DISEASE; IMPACT;
D O I
10.1016/j.kint.2018.12.021
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Limited health literacy is common in patients with chronic kidney disease (CKD) and has been variably associated with adverse clinical outcomes. The prevalence of limited health literacy is lower in kidney transplant recipients than in individuals starting dialysis, suggesting selection of patients with higher health literacy for transplantation. We investigated the relationship between limited health literacy and clinical outcomes, including access to kidney transplantation, in a prospective UK cohort study of 2,274 incident dialysis patients aged 18-75 years. Limited health literacy was defined by a validated Single Item Literacy Screener (SILS). Multivariable regression was used to test for association with outcomes after adjusting for age, sex, socioeconomic status (educational level and car ownership), ethnicity, first language, primary renal diagnosis, and comorbidity. In fully adjusted analyses, limited health literacy was not associated with mortality, late presentation to nephrology, dialysis modality, haemodialysis vascular access, or pre-emptive kidney transplant listing, but was associated with reduced likelihood of listing for a deceased-donor transplant (hazard ratio [HR] 0.68; 95% confidence interval [CI] 0.510.90), receiving a living-donor transplant (HR 0.41; 95% CI 0.19-0.88), or receiving a transplant from any donor type (HR 0.65; 95% CI 0.44-0.96). Limited health literacy is associated with reduced access to kidney transplantation, independent of patient demographics, socioeconomic status, and comorbidity. Interventions to ameliorate the effects of low health literacy may improve access to kidney transplantation.
引用
收藏
页码:1244 / 1252
页数:9
相关论文
共 32 条
  • [1] [Anonymous], ANAL CLUSTERED DATA
  • [2] Socioeconomic deprivation and barriers to live-donor kidney transplantation: a qualitative study of deceased-donor kidney transplant recipients
    Bailey, Phillippa K.
    Ben-Shlomo, Yoav
    Tomson, Charles R. V.
    Owen-Smith, Amanda
    [J]. BMJ OPEN, 2016, 6 (03):
  • [3] Low Health Literacy and Health Outcomes: An Updated Systematic Review
    Berkman, Nancy D.
    Sheridan, Stacey L.
    Donahue, Katrina E.
    Halpern, David J.
    Crotty, Karen
    [J]. ANNALS OF INTERNAL MEDICINE, 2011, 155 (02) : 97 - +
  • [4] Effectiveness of Educational and Social Worker Interventions to Activate Patients' Discussion and Pursuit of Preemptive Living Donor Kidney Transplantation: A Randomized Controlled Trial
    Boulware, L. Ebony
    Hill-Briggs, Felicia
    Kraus, Edward S.
    Melancon, J. Keith
    Falcone, Brenda
    Ephraim, Patti L.
    Jaar, Bernard G.
    Gimenez, Luis
    Choi, Michael
    Senga, Mikiko
    Kolotos, Maria
    Lewis-Boyer, LaPricia
    Cook, Courtney
    Light, Laney
    DePasquale, Nicole
    Noletto, Todd
    Powe, Neil R.
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 2013, 61 (03) : 476 - 486
  • [5] Single-item or two-item literacy screener to predict the S-TOFHLA among adult hemodialysis patients
    Brice, Jane H.
    Foster, Mark B.
    Principe, Stephanie
    Moss, Chailee
    Shofer, Frances S.
    Falk, Ronald J.
    Ferris, Maria E.
    DeWalt, Darren A.
    [J]. PATIENT EDUCATION AND COUNSELING, 2014, 94 (01) : 71 - 75
  • [6] Chronic kidney disease, albuminuria and socioeconomic status in the Health Surveys for England 2009 and 2010
    Fraser, Simon D. S.
    Roderick, Paul J.
    Aitken, Grant
    Roth, Marilyn
    Mindell, Jennifer S.
    Moon, Graham
    O'Donoghue, Donal
    [J]. JOURNAL OF PUBLIC HEALTH, 2014, 36 (04) : 577 - 586
  • [7] Socio-Economic Disparities in the Distribution of Cardiovascular Risk in Chronic Kidney Disease Stage 3
    Fraser, Simon D. S.
    Roderick, Paul J.
    McIntyre, Natasha J.
    Harris, Scott
    McIntyre, Christopher W.
    Fluck, Richard J.
    Taal, Maarten W.
    [J]. NEPHRON CLINICAL PRACTICE, 2012, 122 (1-2): : 58 - 65
  • [8] Indicators of socioeconomic position (part 2)
    Galobardes, B
    Shaw, M
    Lawlor, DA
    Lynch, JW
    Smith, GD
    [J]. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2006, 60 (02) : 95 - 101
  • [9] Live Donor Champion: Finding Live Kidney Donors by Separating the Advocate From the Patient
    Garonzik-Wang, Jacqueline M.
    Berger, Jonathan C.
    Ros, Reside Lorie
    Kucirka, Lauren M.
    Deshpande, Neha A.
    Boyarsky, Brian J.
    Montgomery, Robert A.
    Hall, Erin C.
    James, Nathan T.
    Segev, Dorry L.
    [J]. TRANSPLANTATION, 2012, 93 (11) : 1147 - 1150
  • [10] Griffey Richard T, 2015, J Commun Healthc, V8, P10, DOI 10.1179/1753807615Y.0000000001