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Health literacy in solid-organ transplantation: a model to improve understanding

Authors Chisholm-Burns MA, Spivey CA, Pickett LR

Received 8 August 2018

Accepted for publication 9 October 2018

Published 6 November 2018 Volume 2018:12 Pages 2325—2338

DOI https://doi.org/10.2147/PPA.S183092

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Marie A Chisholm-Burns,1 Christina A Spivey,2 Logan R Pickett1

1University of Tennessee Health Science Center College of Pharmacy, Memphis, TN, USA; 2University of Tennessee Health Science Center College of Pharmacy, Department of Clinical Pharmacy and Translational Science, Memphis, TN, USA

Abstract: Optimizing wellness and health are the most critical goals for patients post solid-organ transplantation. Low health literacy has important implications for wellness and health, increasing patient risk for negative health outcomes. More than 30% of the general US patient population has low health literacy, and solid-organ transplant recipients (SOTRs) may be especially vulnerable to low health literacy and its adverse impact on health outcomes. A comprehensive literature review was conducted and a model was adapted to better depict factors associated with low health literacy. Based on the Paasche-Orlow and Wolf model of health literacy, the Health Literacy Model in Transplantation (HeaL-T) provides a foundation to visually demonstrate the relationships among variables associated with low health literacy and to develop evidence-based strategies to improve care. The model depicts a number of patient and healthcare level factors associated with health literacy, several of which have bi-directional or reciprocal relationships, including access and utilization of healthcare, provider-patient interaction, and self-management/adherence. The impact of these factors and their relationships to SOTR outcomes are reviewed. The HeaL-T represents an important step in developing holistic understanding of the complexity of health literacy in SOTRs and offers clinicians a base from which to design strategies to mitigate adverse health effects including increased hospitalizations, graft failure, and mortality.

Keywords: health literacy, health outcomes, healthcare access, interventions, medication adherence, solid-organ transplantation

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