PD04-09 DOES HEALTH LITERACY IMPACT PATIENT SATISFACTION FOLLOWING ARTIFICIAL URINARY SPHINCTER SURGERY?

Abstract

INTRODUCTION AND OBJECTIVE: Health care providers often overestimate a patient's understanding of health conditions and treatments which can impact preoperative counseling, communication between providers and patients, and ultimately widen health care disparities. We sought to determine whether a patient's health literacy impacts satisfaction following Artificial Urinary Sphincter (AUS) placement for male urinary incontinence. METHODS: Electronic medical records of men who underwent AUS surgery between January 1st 2016 and July 31st 2020 were retrospectively reviewed. We administered a patient satisfaction phone questionnaire that measured overall satisfaction with the procedure using a Likert scale, as well as whether patients would again undergo AUS surgery. The Brief Health Literacy Screen (BHLS), a validated 3 question Likert-style questionnaire, was administered to evaluate health literacy. Ordinal logistic regression was used to determine the association between health literacy and patient satisfaction, adjusting for the following predetermined confounders: patient age, preoperative American Urological Association Symptom Index (AUASI), time from surgery to phone questionnaire, and device functionality. RESULTS: Seventy-six men who underwent AUS surgery and met inclusion criteria were identified. The median age was 70 years with an interquartile range (IQR) of 66-74 years and 88.1% were Caucasian. The median preoperative AUASI was 13 (IQR: 9-19) with a median quality of life score of 5 (IQR: 4-6). Eighty-six percent of men were either satisfied or very satisfied with their surgical procedure, and 86% of men stated that they would again undergo AUS surgery. The median BHLS score was 15 (IQR: 12-15). After adjusting for predetermined confounders, BHLS score was significantly associated with patient satisfaction (OR 1.25, 95% CI 1.02-1.56; p=0.034); however, it was not associated with likelihood to again undergo surgery (p-value = 0.403) (Table 1). CONCLUSIONS: Lower health literacy is associated with lower satisfaction scores following AUS surgery. Understanding a patient's baseline health literacy and level of comprehension of medical treatments and expectations can aid to individualize preoperative counseling, improve subjective patient outcomes, and reduce health disparities.