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Targeting limited health literacy in chronic kidney disease : a multicenter and prospective study
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Orientador(es)
Resumo(s)
Introdução:
Em Portugal, aproximadamente 50 a 60% da população apresenta níveis de literacia em saúde (LS) limitados. A prevalência de LS limitada é, geralmente, maior em pacientes com doença renal crónica (DRC). Este estudo avaliou a LS em pacientes com DRC e apresentou um projeto educativo em doenças glomerulares.
Métodos:
Realizámos um estudo longitudinal, prospetivo e multicêntrico em junho de 2023. Administrámos o European Health Literacy Survey Q16 (HLS-EU-Q16) a 85 adultos com DRC em unidades de nefrologia em Portugal e no Brasil. Dados demográficos, a etiologia de DRC e taxa de filtração glomerular estimada (TFGe) foram colhidos. As respostas foram pontuadas: "muito fácil" e "fácil" pontuaram 1 ponto, "difícil" e "muito difícil" pontuaram 0 pontos. A soma de pontos corresponde ao nível de LS dos participantes: 13-16 "adequado", 9-12 "problemático", 0-8 "inadequado". Literacia em saúde limitada corresponde aos níveis problemático e inadequado.
Resultados:
A idade média dos participantes foi 55 ± 19 anos, com 28.2% (n=24) acima de 70 anos, e 55.3% do sexo masculino (n=47). A média da TFGe foi 51.3 ± 33.7 mL/min/1.73m², com a maioria dos participantes nos estádios 1-3 de DRC (71.8%, n=61). A maioria tinha completado o ensino primário (36.5%, n=31) ou secundário (34.1%, n=29); 47.1% (n=40) são empregados, e 44.7% (n=38) reformados.
A maioria dos pacientes tinha LS limitada (n=47, 55.3%), incluindo 15.3% (n=13) com LS inadequada. Pacientes com LS inadequada apresentaram TFGe mais baixas (27.5±29.1 vs 55.6±32.8 mL/min/1.73m2, p=0.005), idade mais avançada (65±17 vs 53±18 anos, p=0.022) e nível de escolaridade mais baixo (ensino primário: 69.2% vs 30.6%, p=0.049). Análise multivariada revelou que apenas TFGe estava significantemente associada a baixa LS (OR 0.96, IC 95% 0.92-1.00, p=0.034). Conclusões:
A maioria de lusófonos com DRC têm LS limitada. Destaca-se TFGe mais baixas como preditores de LS limitada. Estes achados reforçam a necessidade de programas de LS destinados a pacientes com DRC, particularmente nos estádios avançados de doença.
Através do portal de pacientes da Glomcon Portugal, panfletos em português sobre doenças glomerulares foram disponibilizados à população. Os panfletos servem como intervenções de LS, fornecendo informação sobre doenças glomerulares por meios digitais. São necessários mais estudos para avaliar o impacto destas intervenções em populações portuguesas com DRC.
Introduction: In Portugal, approximately 50 to 60% of patients exhibit limited levels of health literacy (HL). The prevalence of limited HL is generally higher in patients with chronic kidney disease (CKD). This study assessed HL in CKD patients and presented an educational project on glomerular diseases. Methods: We conducted a longitudinal, prospective and multicentric study in June 2023. We administered the European Health Literacy Survey Q16 (HLS-EU-Q16) to 85 adult CKD patients from nephrological care facilities in Portugal and Brazil. Demographic data, CKD etiology and estimated glomerular filtration rate (eGFR) were collected. Answers were scored: "very easy" and "easy" scored 1 point, "difficult" and "very difficult" scored 0 points. The sum of points corresponds to the HL level of participants: 13-16 "adequate", 9-12 "problematic", 0-8 "inadequate". Results: The mean age of participants was 55 ± 19 years, with 28.2% (n=24) over the age of 70, and 55.3% were male (n=47). The mean eGFR was 51.3 ± 33.7 mL/min/1.73m², and most patients were in CKD stages 1-3 (71.8%, n=61). Most had completed primary (36.5%, n=31) or secondary education (34.1%, n=29); 47.1% (n=40) were employed, and 44.7% (n=38) retired. Most patients had limited HL levels (n=47, 55.3%), of which 15.3% (n=13) had inadequate HL and the remaining problematic HL. Patients with inadequate HL were older (65±17 vs 53±18 years, p=0.022), had lower eGFR (27.5±29.1 vs 55.6±32.8 mL/min/1.73m2, p=0.005), and lower educational level (Primary school: 69.2% vs 30.6%, p=0.049). Multivariate analysis revealed that only eGFR was significantly associated with lower HL (OR 0.96, 95% CI 0.92-1.00, p=0.034). Conclusions: Most Portuguese-speakers with CKD had limited HL. Lower eGFR was a significant predictor of worse HL scores. Such findings underscore the need for HL programs targeting these patients, particularly those with advanced disease. Through the Glomcon Portugal patient portal, flyers with information on glomerular diseases have been made freely accessible to patients, in Portuguese. These flyers serve as HL interventions aimed at enhancing disease knowledge through digital media. Further studies are needed to assess the impact of such interventions on the Portuguese-speaking CKD population.
Introduction: In Portugal, approximately 50 to 60% of patients exhibit limited levels of health literacy (HL). The prevalence of limited HL is generally higher in patients with chronic kidney disease (CKD). This study assessed HL in CKD patients and presented an educational project on glomerular diseases. Methods: We conducted a longitudinal, prospective and multicentric study in June 2023. We administered the European Health Literacy Survey Q16 (HLS-EU-Q16) to 85 adult CKD patients from nephrological care facilities in Portugal and Brazil. Demographic data, CKD etiology and estimated glomerular filtration rate (eGFR) were collected. Answers were scored: "very easy" and "easy" scored 1 point, "difficult" and "very difficult" scored 0 points. The sum of points corresponds to the HL level of participants: 13-16 "adequate", 9-12 "problematic", 0-8 "inadequate". Results: The mean age of participants was 55 ± 19 years, with 28.2% (n=24) over the age of 70, and 55.3% were male (n=47). The mean eGFR was 51.3 ± 33.7 mL/min/1.73m², and most patients were in CKD stages 1-3 (71.8%, n=61). Most had completed primary (36.5%, n=31) or secondary education (34.1%, n=29); 47.1% (n=40) were employed, and 44.7% (n=38) retired. Most patients had limited HL levels (n=47, 55.3%), of which 15.3% (n=13) had inadequate HL and the remaining problematic HL. Patients with inadequate HL were older (65±17 vs 53±18 years, p=0.022), had lower eGFR (27.5±29.1 vs 55.6±32.8 mL/min/1.73m2, p=0.005), and lower educational level (Primary school: 69.2% vs 30.6%, p=0.049). Multivariate analysis revealed that only eGFR was significantly associated with lower HL (OR 0.96, 95% CI 0.92-1.00, p=0.034). Conclusions: Most Portuguese-speakers with CKD had limited HL. Lower eGFR was a significant predictor of worse HL scores. Such findings underscore the need for HL programs targeting these patients, particularly those with advanced disease. Through the Glomcon Portugal patient portal, flyers with information on glomerular diseases have been made freely accessible to patients, in Portuguese. These flyers serve as HL interventions aimed at enhancing disease knowledge through digital media. Further studies are needed to assess the impact of such interventions on the Portuguese-speaking CKD population.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2024
Palavras-chave
Doença renal crónica Literacia em saúde Taxa de filtração glomerular European Health Literacy Survey (HLS-EU) Glomcon Portugal Nefrologia