Focused Education Increases Hepatocellular Cancer Screening in Patients with Cirrhosis Regardless of Functional Health Literacy

Focused Education Increases Hepatocellular Cancer Screening in Patients with Cirrhosis Regardless of Functional Health Literacy

Background Health education interventions are successful in modifying lifestyle. Functional health literacy (FHL) can determine patient adherence to clinic visits and procedures and may adversely impact the success of these interventions. Aims We sought to evaluate the hypothesis that a health educa...

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Published in:Digestive diseases and sciences Vol. 66; no. 8; pp. 2603 - 2609
Main Authors: Shaw, Jawaid, Patidar, Kavish R., Reuter, Bradley, Hajezifar, Navid, Dharel, Narayan, Wade, James B., Bajaj, Jasmohan S.
Format: Journal Article
Language:English
Published: New York Springer US 01-08-2021
Springer
Springer Nature B.V
Subjects:
Biochemistry
Cancer
Cancer patients
Diagnosis
Gastroenterology
Health education
Health literacy
Hepatology
Intervention
Liver cancer
Liver cirrhosis
Medical colleges
Medical screening
Medicine
Medicine & Public Health
Oncology
Original Article
Patient compliance
Patient education
Transplant Surgery
Health literacy
Screening
Education
Liver cirrhosis
S-TOFHLA
Hepatocellular cancer
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Summary:Background Health education interventions are successful in modifying lifestyle. Functional health literacy (FHL) can determine patient adherence to clinic visits and procedures and may adversely impact the success of these interventions. Aims We sought to evaluate the hypothesis that a health education intervention would improve compliance with hepatocellular cancer (HCC) screening and that poor FHL would reduce such compliance. Methods We assessed FHL using a short version test of functional health literacy in adults (STOFHLA). Cirrhotic patients free of HCC were prospectively enrolled from clinics and provided an educational intervention consisting of focused physician-led discussion regarding cirrhosis and HCC, along with written material on these topics for the subject to review at home. Patients were subsequently followed for 6 months (prospective time period), and the same cohort’s clinic/HCC screening behavior between 6 and 12 months prior to the educational intervention (retrospective time period) was compared. Results In total, 104 cirrhotic patients (age 60.01 ± 8.58 years, 80% men, MELD 12.70 ± 5.76) were included. Of these, 89 (85.57%) of patients had educational level 12th grade and higher. There were 76% ( n  = 79) with adequate, while 24% ( n  = 25) had inadequate/marginal FHL on S-TOHFLA. The number of HCC-related imaging increased from 59 (56.7%) to 86 (82.6%, p  < 0.0001) post-education in the prospective compared to prior time period which was similar regardless of FHL. Conclusions While the educational intervention was successful in improving compliance with HCC screenings, FHL status did not impact the power of this intervention. Hence, the combination of specific verbal information, along with targeted written material, improved compliance with clinic visits and liver imaging for HCC.
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ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-020-06583-x