Dominic Taylor|Simon Fraser|J. Andrew Bradley|Clare Bradley|Heather Draper|Wendy Metcalfe|Gabriel C. Oniscu|Charles Tomson|Rommel Ravanan|Paul Roderick
A Systematic Review of the Prevalence and Associations of Limited Health Literacy in CKD
University of Southampton|National Health Service|University of Southampton|University of Cambridge|National Institute for Health Research|Royal Holloway University of London|University of Warwick|Edinburgh Royal Infirmary|Freeman Hospital|National Health Service|University of Southampton
selfmanagement decisionmaking skills required manage ckd successfully may diminished low health literacy 2012 review identified five papers reporting prevalence limited health literacy ckd largely united states dialysis populations literature expanded considerably sincewe used systematic review pooled prevalence analysis metaregression exploration heterogeneity studies patients ckd stagesfrom 433 studies 15 new studies met inclusion criteria analyzed together five studies 2012 review included 13 crosssectional surveys five cohort studies using baseline data two using baseline clinical trial data 19 20 united states total 12324 patients studied 3529 nondialysis ckd 5289 dialysis 2560 transplant 946 unspecified ckd median 1985 iqr 1285260 per study median prevalence limited health literacy within studies 23 iqr 1633 pooled prevalence 25 95 confidence interval 20 30 significant betweenstudy heterogeneity i297 pooled prevalence limited health literacy 25 95 confidence interval 16 33 i297 among patients ckd dialysis 27 95 confidence interval 19 35 i296 among patients dialysis 14 95 confidence interval 7 21 i297 among patients transplants higher proportion nonwhite participants associated increased limited health literacy prevalence p004 participant age p040 within studies nonwhite ethnicity low socioeconomic status consistently independently associated limited health literacy studies low moderate quality withinstudy participant selection criteria potential introduce biaslimited health literacy common ckd especially among individuals low socioeconomic status nonwhite ethnicity implications design selfmanagement decisionmaking initiatives promote equity care improve quality lower prevalence among patients transplants may reflect selection patients higher health literacy transplantation either less comorbidity group direct effect health literacy access transplantation