46 Study Characteristics Study Results Study CKD-pop(N) Country Design Measure (% LHL) Q Mechanism(s) Association of health literacy with mediator within this mechanism(s) or other result related to mechanism Association of health literacy or mediator with health outcome? Adeseun et al., 2012(43) 5(D) (72) USA Crosssectional sTOFHLA1 (21%) - Self-care management No: LHL with history of tobacco use. Yes: LHL with higher blood pressure. No: LHL with other lifestyle markers, such as BMI. Green et al., 2011(47) 5(D) (288) USA Cohortstudy REALM1 (16%) - Self-care management No: LHL with quality of life. Yes: LHL with burden of comorbidities. No: LHL with symptom burden, depression, dialysis adequacy and lab values (i.e. albumin, hemoglobin). Foster et al., 2011(58) 5(D) (62) USA Crosssectional sTOFHLA1 (30.3%) - Self-care management No: LHL with disaster preparedness (such as having extra medications). No results reported on health outcomes. Studies with results on mechanisms related to utilization of care (n=10) Taylor et al. 2019(39) 5(D) (2274) United Kingdom Cohortstudy SILS1 (24%) + Utilization of care Yes: LHL with reduced access to deceased-donor transplant listing and receiving a transplant from a living donor. This is likely related to patients’ preparation. No: LHL with pre-emptive wait listing or dialysis modality. No: LHL with catheter use or mortality. Warsame et al. 2018(38) 4-5(D) (1578) USA Cohortstudy Brief HLS1 (8.9%) + Utilization of care Yes: LHL with lower likelihood of being waitlisted for kidney transplant. Yes: LHL with lower likelihood of undergoing living donor transplant and greater risk of waitlist mortality. Green et al., 2013(65) 5(D) (260) USA Cohortstudy REALM1 (16%) + Utilization of care Yes: LHL with missed dialysis treatments, more emergency department visits, and more hospitalization. No: LHL with abbreviating dialysis treatments. Yes: LHL with higher prevalence of co-morbidities and fistula use. No: LHL with mortality, lab values or receiving transplant. Dageforde et al., 2014(44) 5(T) (360) USA Crosssectional SLS1 -10% +/- Utilization of care Other: LHL more prevalent in patients with a deceased donor (14%) than in patients with a living donor (9%). Living donors have even lower prevalence of LHL (6%). No results reported on health outcomes. Levine et al., 2018(66) 2-5 (142) USA Cohortstudy NVS1 -12% - Utilization of care No: LHL with emergency department visits, hospitalization, or length of hospital stay. No results reported on health outcomes. Vilme et al. 2018(63) 4-5(D) (155) USA Crosssectional REALM1 REALM-sf1 (n.a) - Utilization of care No: LHL with patient interest in receiving a kidney from a living donor or with facilitators or barriers to pursue a living donor kidney transplantation, in a cohort of African-Americans. No results reported on health outcomes.
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