Patients who struggle to read, absorb, and follow healthcare instructions may be more likely to contract an infection after surgery, according to the results of new research.

Investigators from the University of Alabama at Birmingham (UAB) Hospital examined 270 patients who underwent colon or rectal operations. Using the Brief Health Literacy Screening Tool, researchers measured these patients’ literacy, placing them in three categories: 213 demonstrated adequate health literacy, 38 demonstrated marginal health literacy, and 19 demonstrated low health literacy. Patients with low literacy were 4.5 times more likely to contract an infection one month after surgery vs. those with adequate literacy.

“It’s important to understand that patients with limited health literacy might be at higher risk for an infection after surgery so we can start to understand why and design interventions and tools to better support those patients,” Lauren Theiss, MD, a third-year surgical resident at UAB School of Medicine and lead investigator, said in a statement.

In addition to 30-day complications, the authors studied length of stay, readmission rates, and mortality statistics. They also looked closely at what level patients complied with UAB Hospital’s enhanced recovery program, a specialized guide designed to help patients experience the best post-surgical outcomes. On top of demographics, socioeconomics, and other patient-level factors, overly intricate institutional instructions play into poor health literacy.

Considering the results of this study, UAB surgeons have committed to improving the way they communicate information to patients. This may range from easier-to-understand language and more visual elements in collateral patients receive to surgeons taking their time when delivering instructions.

Read much more about this subject in the upcoming November issue of Same-Day Surgery.