Best of the Best Gen Surg - Limited Health Literacy is Associated with Reduced Adherence to ERP Components. - Dr. Shao

Health literacy is defined as the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.

Health literacy is modifiable and health literacy-based interventions have been shown to improve outcomes and patient experience.

Patients with lower health literacy are more likely to have higher health care costs, higher rates of hospital and emergency room visits, and higher mortality rates.

Patients with lower health literacy are less likely to follow treatment plans.

The presenter's group previously showed that limited health literacy is associated with increased complications compared to patients with higher health literacy.

Many studies have shown that increased adherence to components of enhanced recovery is associated with improved postoperative outcomes.

The study was a retrospective cohort study from December 2018 to November 2021 of elective inpatient colorectal surgeries tracked by the institutional ACS NSQIP database.

Seven ERP adherence variables were extracted from the NSQIP database and cross-referenced with a health literacy database that tracked patients' brief health literacy scores measured in clinic.

In the study cohort, patients on average were about 56 years old, about 70% white, a quarter black, majority female, with mean BMI of about 30.

In the study cohort, 12% had a surgical site infection within 30 days of surgery, average length of stay was about 5.5 days, and about 10% of patients were readmitted within 30 days.

Only two factors were associated with increased ERP adherence: increased health literacy and a diagnosis of cancer.

There is a direct linear correlation between increased health literacy score and increased percent adherence to the seven components of ERP that were tracked.

Black race, case duration, ostomy placement, and the diagnosis of IBD are associated with increased length of stay.

The only protective factor for decreased length of stay was adherence to the different components of enhanced recovery.

Higher health literacy is independently associated with greater ERP adherence.

Enhanced recovery at UAB has been a big deal for the last decade, with initial great uptake in teaching among nurses and successful closing of the gap in disparities in care between black and white patients.

Travel nurses are not as well trained in enhanced recovery because they are not from the institution and travel to many different institutions.