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Peer-reviewedCC BY-NC 4.0Clinical Transplantation

Correlation Between Health Literacy and Tacrolimus Variability in Solid Organ Transplant Recipients

Abstract

Background: Adherence to immunosuppressive therapy is crucial for successful outcomes in solid organ transplantation. Tacrolimus intra-patient variability (%CV) is a validated marker of adherence and has been associated with graft outcomes. Health literacy (HL), a modifiable factor, may influence this variability, but its role remains unexplored. Methods: We conducted a prospective observational study including adult kidney, liver, and lung transplant recipients receiving tacrolimus. HL was assessed using the Short Test of Functional Health Literacy in Adults (S-TOFHLA); a score <23 indicated insufficient HL. Tacrolimus %CV was calculated over 6 months post-discharge. Linear regression models, adjusted for sociodemographic variables, evaluated the association between HL and %CV. Results: Ninety-eight patients were included (kidney: n = 38, liver: n = 24, lung: n = 36). Patients with insufficient HL had higher %CV than those with sufficient HL (31.5% vs. 16.1%, p < 0.05). HL remained independently associated with %CV after adjusting for age and transplant type (β = -1.60, SE = 0.17, p < 0.05). The final model explained 53% of %CV variability. Conclusions: HL is independently associated with tacrolimus variability. HL screening and targeted educational interventions may help improve medication stability and long-term transplant outcomes.

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BibTeX
@article{bacle2026correlation,
  title = {{Correlation Between Health Literacy and Tacrolimus Variability in Solid Organ Transplant Recipients}},
  author = {Astrid Bacle and Pauline Blanc-Petitjean and Elouan Demay and Sarah Pelletier and Virginie Migeot and Marie‐claude Langevin and Jean‐philippe Adam},
  journal = {Clinical Transplantation},
  year = {2026},
  month = oct,
  doi = {10.1111/ctr.70304},
  url = {https://hal.science/hal-05399945v1},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Correlation Between Health Literacy and Tacrolimus Variability in Solid Organ Transplant Recipients
AU  - Astrid Bacle
AU  - Pauline Blanc-Petitjean
AU  - Elouan Demay
AU  - Sarah Pelletier
AU  - Virginie Migeot
AU  - Marie‐claude Langevin
AU  - Jean‐philippe Adam
PY  - 2026
DA  - 2026/10/06
JO  - Clinical Transplantation
DO  - 10.1111/ctr.70304
UR  - https://hal.science/hal-05399945v1
AB  - Background: Adherence to immunosuppressive therapy is crucial for successful outcomes in solid organ transplantation. Tacrolimus intra-patient variability (%CV) is a validated marker of adherence and has been associated with graft outcomes. Health literacy (HL), a modifiable factor, may influence this variability, but its role remains unexplored. Methods: We conducted a prospective observational study including adult kidney, liver, and lung transplant recipients receiving tacrolimus. HL was assessed using the Short Test of Functional Health Literacy in Adults (S-TOFHLA); a score <23 indicated insufficient HL. Tacrolimus %CV was calculated over 6 months post-discharge. Linear regression models, adjusted for sociodemographic variables, evaluated the association between HL and %CV. Results: Ninety-eight patients were included (kidney: n = 38, liver: n = 24, lung: n = 36). Patients with insufficient HL had higher %CV than those with sufficient HL (31.5% vs. 16.1%, p < 0.05). HL remained independently associated with %CV after adjusting for age and transplant type (β = -1.60, SE = 0.17, p < 0.05). The final model explained 53% of %CV variability. Conclusions: HL is independently associated with tacrolimus variability. HL screening and targeted educational interventions may help improve medication stability and long-term transplant outcomes.
SN  - 0902-0063
SN  - 1399-0012
ER  -