Health Literacy Not Associated with Chronic Kidney Disease Awareness

• Main Authors: Milda R. Saunders (Author), Ashley Snyder (Author), Marshall H. Chin (Author), David O. Meltzer (Author), Vineet M. Arora (Author), Valerie G. Press (Author)
• Format: Book
• Published: SLACK Incorporated, 2017-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3928/24748307-20170608-01; 2474-8307
• Keywords: chronic kidney disease; health literacy; health disparity; Public aspects of medicine; RA1-1270
• Source: Health Literacy Research and Practice, Vol 1, Iss 3, Pp e117-e127 (2017)

Background: Patient awareness of their chronic kidney disease (CKD) and health literacy (HL) are both important for adherence to therapies that slow CKD progression and to reduce risk of complications. Little is known about the association between HL and CKD awareness. Objective: We sought to determine if patient HL is associated with CKD awareness. Methods: We conducted a cross-sectional study of general medicine inpatients at an urban academic medical center discharged between June 2011 and July 2013 with CKD, defined as having at least one CKD International Classification of Diseases, ninth revision code (585.0-585.9), among their first 20 admission diagnoses. Logistic regression was used to analyze the influence of HL, demographic, clinical, and health care use covariates on the likelihood of patients' CKD awareness. Our primary outcome was patient awareness of their CKD, defined as correct patient self-report of "kidney problems." We used the Brief Health Literacy Screen, a three-item verbal questionnaire, to assess HL. Key Results: Among 1,308 patients with CKD, awareness of CKD was 33%, and 48% had adequate HL. However, CKD awareness was not associated with HL even among patients with stage 4 or 5 CKD. In multivariable logistic regression, greater awareness was associated with being a woman, younger than age 50 years, married, White, having hypertension, and having a higher CKD stage (all p < .05). In stratified analyses, patients with hypertension had greater CKD awareness, regardless of HL or diabetes status (p < .05). Conclusions: Among hospitalized patients with CKD, both CKD awareness and HL are low and inadequate. Surprisingly, patients' knowledge of their CKD diagnosis was not related to patients' HL. Patients with hypertension who young, white, or married may be receiving or retaining more education related to CKD. More work is needed on how to effectively communicate CKD diagnosis to prevent widening health disparities.