The Impact of Health Literacy on the ERCP Process

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive method commonly used for the diagnosis and treatment of hepatopancreaticobiliary diseases. The aim of this study is to assess whether there is a relationship between Health Literacy (HL) levels and the ERCP process. 
 Material and Methods: The study prospectively evaluated the HL data of 72 patients who had ERCP in our hospital between July-November 2020. The Turkish version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to assess health literacy. The patients’ demographic characteristics, duration of referral to hospital, duration of the ERCP procedure, white blood cells (WBC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), and total-direct bilirubin levels and HLS-EU-Q47 results were recorded and evaluated.
 Results: In our study, 77.7% of the patients had insufficient HL levels. The median body mass index (BMI) was statistically higher in patients with an insufficient HL level (p= .046). GGT, total and direct bilirubin levels were higher in patients with a low HL level (p= .009, p= .031, p= .008, respectively). The assessment of the duration of referral for ERCP revealed that the median duration of referral was statistically significantly longer in patients with an insufficient HL level (p< .001). The median duration of cannulation during ERCP was statistically higher in patients with an insufficient HL level (p= .002).
 Conclusions: The level of Health Literacy affects the early diagnosis and the success of the procedure in hepatopancreaticobiliary diseases that require ERCP.