Introduction: An adequate level of health literacy is essential for the caregivers of children with kidney transplants to provide optimal care and adhere to medications post-transplant. An estimated 55% of adult Canadians have below adequate health literacy.1 In adult kidney transplant recipients, low health literacy has been associated with poorer patient outcomes, including increased serum creatinine levels.2 Little is known about health literacy in families with children who receive transplants. In a study of children with liver transplants, parental health literacy scores were significantly correlated with number of biopsy-proven rejection episodes and number of hospitalizations, but were not correlated with any measure of medication adherence.3 The clinical significance of inadequate caregiver health literacy in the context of pediatric kidney transplantation has not been studied.
Methods: The purpose of this study is to describe the landscape of health literacy within our program, and to determine if a relationship between health literacy level exists with clinical outcomes such as medication adherence and frequency of contact with a tertiary-care centre. The ‘Newest Vital Sign (NVS)’ is a validated health literacy screening test that consists of 6 verbally administered questions to assess both health literacy and numeracy.4 Since October 2020, the NVS tool has been administered to caregivers or patients as part of their routine clinical assessment when referred to our kidney transplant program. Literacy assessments performed between October 2020 and September 2022 were included in analysis.
Results and Conclusion: Of the 41 patients or caregivers screened using the NVS, 10% demonstrated a high likelihood of limited literacy, while 32% demonstrated the possibility of limited literacy. Analysis of the relationship between health literacy level and the frequency of tertiary-care visits, number of days hospitalized, adherence to immunosuppressant medication and decline in eGFR at 1 year post-transplant is pending.