The effect of health literacy on treatment adherence in maintenance haemodialysis patients: a cross-sectional study

Background: Treatment non-adherence may be prevalent in patients requiring haemodialysis (HD). Health literacy plays an important role in self-management. However, most research has only assessed basic literacy skills in the haemodialysis cohort. Aim: To determine the association between a multidimensional concept of health literacy and self-reported treatment adherence in HD patients. Method: A cross-sectional survey was undertaken with 42 maintenance HD patients from two South Australian dialysis centres. The Functional, Communicative and Critical Health Literacy (FCCHL) tool was used to assess health literacy. Treatment adherence was measured using a self-report tool developed by the researchers. Results: Higher overall health literacy was associated with increased adherence to food (OR 3.66; 95% CI 1.08–12.43; p=0.038), fluid (OR 4.92; 95% CI 1.13–21.35; p=0.033) and medications (OR 11.88; 95% CI 2.26–62.44; p=0.003). Conclusion: Interventions should be designed to facilitate a multidimensional concept of health literacy to assist patients to follow treatment recommendations.