Introduction: An adequate level of functional health literacy is essential for transplant recipients and caregivers to comprehend complex information and be adherent to recommendations. Given the limited data about health literacy in pediatric solid organ transplant recipients, the purpose of this project is to study prospectively, the association between health literacy, adherence and readiness to transition in pediatric kidney transplant recipients.

Methods: Data were collected from 60 subjects (33 patients & 27 parents), who were ≥ 6 months post-transplant. Health literacy was assessed using Short Test of Functional Health Literacy (S-TOFHLA) and numeracy literacy using Newest Vital Signs (NVS). Barriers to adherence was assessed via validated Adolescent and Parent Medication Barriers Scales (AMBS and PMBS respectively). Readiness to Transition Questionnaire (RTQ) and Pediatric Quality of Life (PedsQL) was also administered.

Results: Patients were 15-21 years old (median age 17), with 61% males; 51% Caucasian, 35% blacks. 73% patients and 59% parents had inadequate numeracy literacy while 97% patients and 96% parents had adequate health literacy. Patients with lower NVS scores trended towards higher adolescent responsibility score in RTQ (Wilcoxon p=0.068). AMBS and PedsQL did not correlate with S-TOFHLA or NVS. Patients showing greater adherence (as estimated by 2 of 3 most recent drug levels being within target) reported greater regimen adaptation/cognitive issues (p=0.03) and recognition of barriers in AMBS (p=0.03). There was a negative correlation of PedsQL to total AMBS score (r=-0.61), disease frustration (r=-0.60), regimen adaptation (r=-0.56) and ingestion issues (r=-0.43). Among parents, NVS negatively correlated with perception of ingestion issues for their child (r=-0.74).

Conclusion: A majority of patients and parents showed inadequate numeracy literacy, despite adequate health literacy. Although these patients may remain more dependent on their parents, they may also have a skewed perception regarding readiness to transition which can negatively impact outcomes. Health literacy, especially numeracy literacy, in transplant recipients is a hidden barrier, which needs to be recognized and overcome to improve long-term outcomes.

CITATION INFORMATION: Kamel M., McCracken C., Wilkerson A., Alexander N., Gazmararian J., George R. Effects of Health Literacy and Numeracy Literacy on Adherence, Quality of Life and Readiness to Transition in Pediatric Renal Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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