Assessment of Transplant Health Literacy of Liver Transplant Candidates and Their Caregivers.
1Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA
2Codman Center for Clinical Effectivness in Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA
3Transplantation, Lahey Hospital and Medical Center, Burlington, MA.
Meeting: 2016 American Transplant Congress
Abstract number: B57
Keywords: Efficacy, Informed consent, Liver transplantation, Safety
Session Information
Date: Sunday, June 12, 2016
Session Name: Poster Session B: Disparities in Access and Outcomes
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Purpose: All transplant programs provide education sessions and instructional material to their patients to improve health literacy. However, their efficacy is unknown. We piloted a novel health literacy tool to assess liver transplant literacy in patients and their caregivers before and after education provided by a single transplant center.
Methods:The Rapid Estimate of Adult Literacy in Medicine-Transplantation word recognition test was adapted by adding liver transplant terms to form the REALM-Liver, a test of 82 terms. The REALM-Liver was administered to liver transplant candidates and their caregivers before and after a transplant education session. Correct pronunciation earned a raw score of 1 point. Data was analyzed by the Wilcoxon Rank-Sum and Wilcoxon Signed-Rank tests.
Results: One hundred participants (52 patients; 48 caregivers) at a single center completed the REALM-Liver study. Patient and caregiver scores showed statistically significant improvement post education; the 1-2% change in scores corresponded to approximately one additional answer out of 82 correct. Caregivers scored better than patients at each time point (Table 1). Commonly mispronounced words included those considered basic to liver transplantation (ex. hepatic, total bilirubin, creatinine, trough level).
Conclusion: Despite completing an education session, patients and their caregivers were not able to recognize all terms considered basic to liver transplantation, suggestive of sub-optimal liver transplant health literacy. While statistically significant, these literacy improvements are marginal and suggest current transplant education programs may be inadequate. As the quality of transplant education and its impact on health literacy is further assessed, the role of caregivers should also be explored since they score better than patients.
|
Pre education REALM-Liver score median % correct (IQR) |
Post education REALM-Liver score median % correct (IQR) |
p-value | |
| Patients | 86.6 (78.7-91.5) | 87.8 (79.3-93.9) | <0.005 |
| Caregivers | 91.5 (84.8-95.1) | 93.9 (87.2-96.3) | <0.005 |
| p-value | <0.005 | <0.005 |
CITATION INFORMATION: Bababekov Y, Fong Z, Adler J, Yeh H, Chang D, Pomposelli J. Assessment of Transplant Health Literacy of Liver Transplant Candidates and Their Caregivers. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Bababekov Y, Fong Z, Adler J, Yeh H, Chang D, Pomposelli J. Assessment of Transplant Health Literacy of Liver Transplant Candidates and Their Caregivers. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/assessment-of-transplant-health-literacy-of-liver-transplant-candidates-and-their-caregivers/. Accessed July 21, 2018.« Back to 2016 American Transplant Congress