Health literacy has become increasingly recognized as a vital component of decision-making and communication in pediatrics. Now, researchers have found an association between lower health literacy and disease outcomes in a chronic pediatric disease. Borges et al. recently published their findings in Pediatrics (10.1542/peds.2016-1961). They studied a cohort of children ages 1-18 years with nephrotic syndrome and their parents, assessing for reading comprehension, numeracy, and long-term outcomes of their disease. While numeracy was not associated with any outcomes, poor reading comprehension of parents boded poorly for children with nephrotic syndrome. When parents demonstrated lower reading comprehension scores, their children were at higher risk of first relapse, more likely to have frequently relapsing disease, and less likely to achieve complete remission.
These results were independent of immigration status, education, and family income.The silver lining in these findings was that more than 80% of parents demonstrated adequate reading comprehension. However, this leaves nearly 20% of children with nephrotic syndrome at a significant disadvantage. Future studies should focus on how to best support families who demonstrate poor reading comprehension. As is often the case in pediatrics, the best treatment for patients is likely more than just a medication.