A randomized controlled trial to evaluate utilization of physical activity recommendations among patients of cardiovascular healthcare centres in Eastern Slovakia: study design and rationale of the AWATAR study

Two-Year Follow-Up of a Communication Intervention on Medication Adherence and Health Literacy in Kidney Transplanted Recipients-A Randomised Controlled Study

BACKGROUND

Patients with chronic conditions, including kidney transplanted recipients, are required to actively participate in their continuous care and maintain motivation to adhere consistently to treatment.

OBJECTIVES

Our study aimed to test long-term effectiveness of a new health communication intervention designed to improve on medication adherence and health literacy in kidney transplant recipients 2 years following transplantation.

DESIGN

A randomised controlled non-blinded study was conducted between March 2020 and August 2023.

PARTICIPANTS

One hundred and ninety-five kidney transplant recipients were included.

MEASUREMENTS

Primary outcomes were self-reported medication adherence, measured by the BAASIS questionnaire, and health literacy, measured by the Health Literacy Questionnaire. The response rate was 87% (170 of 195 patients).

RESULTS

This study showed a significant difference between groups in favour of the intervention group for medication adherence (p < 0.02) and two essential Health Literacy Questionnaire domains-'navigating the health care system' (p < 0.02) and 'having social support for health' (p > 0.03)-2 years after transplantation. Regarding health literacy, three Health Literacy Questionnaire domains showed a significant correlation with adherence: 'having sufficient information to manage health' (p < 0.04), 'having social support for health' (p < 0.04), and 'ability to understand health information well enough to know what to do' (p < 0.05).

CONCLUSION

The findings in the study highlight the pivotal role of health communication in enhancing medication adherence and supporting important health literacy aspects for kidney transplant recipients.

Effectiveness of a health communication intervention on health literacy in the first year following kidney transplantation - A randomized controlled study

OBJECTIVE

This study aimed to evaluate the effect of a new health communication intervention focusing on knowledge management skills on health literacy and medication adherence during the first year following kidney transplantation.

METHODS

We randomized 195 patients during 2020-2021, to either intervention- or control group. Questionnaires were completed at baseline and at 12 months post-transplantation with a 12-month response rate of 84%. Health literacy was measured by the multidimensional Health Literacy Questionnaire (HLQ) instrument. Medication adherence was measured by the self-reported questionnaire (BAASIS©).

RESULTS

Results showed that the intervention group had a significant increase in 2 HLQ domains compared to the control group capturing the "ability to appraise health information" Domain 5, (p-value = 0.002) and the "ability to navigate the healthcare system" Domain 7, (p-value <0.04). The effect sizes of SRM were 0.49 (Domain 5) and 0.33 (Domain 7). Medication adherence was comparable in the groups at any measure points.

CONCLUSIONS

This study contributes to important knowledge about how a health communication intervention focusing on knowledge translation using motivational interviewing techniques positively strengthens health literacy in kidney transplant recipients.

PRACTICAL IMPLICATIONS

Current patient education practice may benefit from focusing on knowledge translation in combination with motivational interview technique.