Health Literacy, Knowledge, and Patient Satisfaction Before Kidney Transplantation

Background. Poor health literacy is associated with inferior outcomes in kidney transplant recipients, and knowledge remains suboptimal in this population. The goal of this study was to characterize the health literacy, kidney transplant knowledge, medication beliefs, and education satisfaction in a cohort of patients waiting to undergo kidney transplantation. Methods. All patients on the wait-list in 1 Canadian center were invited to participate in the study. A research assistant administered the Short Test of Functional Health Literacy in Adults and its numeracy section, the Beliefs about Medicines Questionnaire, the Kidney Transplant Understanding Tool, and questions regarding satisfaction. Descriptive and univariate statistics were calculated between demographic variables and the assessments. Results. Thirty-nine percent of patients (41 of 106) patients participated in the study. Overall, 95% and 86% were defined as having adequate health literacy and numeracy, respectively. The mean score on the Kidney Transplant Understanding Tool was 79%, and the majority (97.4%) had strong beliefs regarding the necessity of medication and little concern about adverse effects (73.8%). Participants with higher literacy scores had increased knowledge (r = 0.52; P =.05), understanding of why antirejection pills are necessary (r = 0.38; P =.05), and confidence about taking posttransplant medications (r = 0.32; P =.05). Overall, 30.7% were unsatisfied with their education regarding medications, and 22.5% were unsatisfied with what to expect after the transplant. Conclusions. Before transplantation, health literacy, transplant knowledge, and scores on the Beliefs about Medicines Questionnaire were high in this cohort of patients. However, patient satisfaction regarding educational content remained suboptimal.