title: Health Literacy Status Affects Outcomes for Patients Referred for Transplant.
abstract: It is hypothesized that limited health literacy affects outcomes for patients referred for transplant; however, research has not examined this for all types of end-stage organ disease.
  
  
  
  The purpose of this study was to determine whether health literacy and cognitive impairment were related to listing for transplant and posttransplant outcomes.
  
  
  
  Chart reviews were conducted on 398 patients who completed a required psychiatric evaluation before transplant listing. Information gathered from these evaluations included reading ability, math ability, and cognitive functioning. Variables before transplant and 6 months after transplantation were also collected.
  
  
  
  Patients with limited reading ability were less likely to be listed for transplant (p = .018) and were more likely to be removed from listing (p = .042), to miss appointments prelisting (p = .021), and to experience graft failure (p = .015). Patients with limited math ability were less likely to be listed (p = .010) and receive a transplant (p = 0.031), and more likely to be readmitted posttransplant (p = .029). Patients with cognitive impairment were less likely to be listed (p = .043) and to receive a transplant (p = .010).
  
  
  
  To achieve superior transplant access and outcomes, transplant providers should regularly screen patients for limited health literacy and cognitive impairment. Future studies should evaluate whether interventions result in better outcomes for these patients.
authors.affiliation: Behavioral Health, Henry Ford Health System, Detroit, MI. Electronic address: Lmatero1@hfhs.org.
authors.forename: Lisa Renee
authors.initials: LR
authors.lastname: Miller-Matero
authors.affiliation: Behavioral Health, Henry Ford Health System, Detroit, MI; Transplant Institute, Henry Ford Health System, Detroit, MI.
authors.forename: Kelly
authors.initials: K
authors.lastname: Bryce
authors.affiliation: Behavioral Health, Henry Ford Health System, Detroit, MI.
authors.forename: Maren E
authors.initials: ME
authors.lastname: Hyde-Nolan
authors.affiliation: Behavioral Health, Henry Ford Health System, Detroit, MI.
authors.forename: Kate Elizabeth
authors.initials: KE
authors.lastname: Dykhuis
authors.affiliation: Behavioral Health, Henry Ford Health System, Detroit, MI; Transplant Institute, Henry Ford Health System, Detroit, MI.
authors.forename: Anne
authors.initials: A
authors.lastname: Eshelman
authors.affiliation: Transplant Institute, Henry Ford Health System, Detroit, MI.
authors.forename: Marwan
authors.initials: M
authors.lastname: Abouljoud
mesh_terms: D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004522:Educational Status; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000523:psychology*; D006085:Graft Survival; D057220:Health Literacy; D006353:Heart-Assist Devices / Q000523:psychology; D006801:Humans; D008297:Male; D008433:Mathematics; D008824:Michigan; D008875:Middle Aged; D016377:Organ Transplantation / Q000523:psychology*; D010359:Patient Readmission / Q000706:statistics & numerical data; D018579:Patient Selection; D011932:Reading; D012017:Referral and Consultation; D012307:Risk Factors; D016896:Treatment Outcome
keywords: cognitive functioning; literacy; numeracy; outcomes.; transplant