Title: The impact of health literacy on adolescent and young adult pediatric liver transplant recipients
Source: Liver Transplantation 2023, Oct 9. [E-publication]
Date of publication: October 2023
Publication type: Article
Abstract: Background: Pediatric liver transplant (LT) recipients have increased rates of morbidity and mortality following transfer to adult health care providers. The role of health literacy (HL) has not been adequately assessed in this population and may be an unrecognized barrier to successful health care transition (HCT). We sought to determine the impact of HL for patients and their caregivers on measures of transition readiness (TR), adherence, health-related quality of life (HRQoL) and medical outcomes following pediatric LT.
Methods: This is a single center study of pediatric LT recipients transplanted between the ages of 12 and 26 from October 2016 through August 2020. Patients and caregivers completed 4 surveys to evaluate TR, HRQoL, and HL. Clinical outcomes were stratified based on the presence or absence of adequate HL.
Results: Limited HL was identified in 57.0% of recipients and 47.4% of caregivers. Patients with limited HL were more likely to be younger in age (p=0.004), Hispanic (p=0.003), and less likely to have obtained a high school diploma or equivalent (p<0.001). Patients with adequate HL demonstrated significantly higher levels of TR (p<0.001). Patient HL did not impact HRQoL, adherence or medical outcomes. Caregiver HL did not impact patient outcomes or adherence, though higher levels of caregiver education were associated with adequate patient HL (p=0.049).
Conclusions: This study demonstrates that limited HL is associated with decreased measures of TR. Inadequate HL may be an unrecognized barrier to successful HCT. Regular assessment of HL may provide an opportunity for intervention prior to transfer of care. Future studies should investigate the impact of these interventions on long-term medical outcomes.