{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T21:01:14Z","timestamp":1785445274324,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adherence to immunosuppressive therapy is crucial for successful outcomes in solid organ transplantation. Tacrolimus intra\u2010patient 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2010TOFHLA); a score &lt;23 indicated insufficient HL. Tacrolimus %CV was calculated over 6\u00a0months post\u2010discharge. Linear regression models, adjusted for sociodemographic variables, evaluated the association between HL and %CV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety\u2010eight patients were included (kidney:\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a038, liver:\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a024, lung:\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a036). Patients with insufficient HL had higher %CV than those with sufficient HL (31.5% vs. 16.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). HL remained independently associated with %CV after adjusting for age and transplant type (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0\u22121.60, SE\u00a0=\u00a00.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). The final model explained 53% of %CV variability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HL is independently associated with tacrolimus variability. HL screening and targeted educational interventions may help improve medication stability and long\u2010term transplant outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70304","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:50:18Z","timestamp":1763466618000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlation Between Health Literacy and Tacrolimus Variability in Solid Organ Transplant Recipients"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3600-1307","authenticated-orcid":false,"given":"Astrid","family":"Bacle","sequence":"first","affiliation":[{"name":"Univ Rennes CHU Rennes Inserm EHESP Irset (Institut De Recherche en Sant\u00e9 Environnement Et Travail)\u2010UMR_S 1085  Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Blanc\u2010Petitjean","sequence":"additional","affiliation":[{"name":"Univ Rennes CHU Rennes Inserm EHESP Irset (Institut De Recherche en Sant\u00e9 Environnement Et Travail)\u2010UMR_S 1085  Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elouan","family":"Demay","sequence":"additional","affiliation":[{"name":"Pharmacie Clinique et Bon Usage (PCBU) Centre Hospitalier de Rennes Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Pelletier","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Centre Hospitalier de L'universit\u00e9 De Montr\u00e9al  Montr\u00e9al Quebec Canada"},{"name":"Research Center of Centre Hospitalier De L'universit\u00e9 De Montr\u00e9al  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Migeot","sequence":"additional","affiliation":[{"name":"Univ Rennes CHU Rennes Inserm EHESP Irset (Institut De Recherche en Sant\u00e9 Environnement Et Travail)\u2010UMR_S 1085  Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Claude","family":"Langevin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Centre Hospitalier de L'universit\u00e9 De Montr\u00e9al  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Philippe","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Centre Hospitalier de L'universit\u00e9 De Montr\u00e9al  Montr\u00e9al Quebec Canada"},{"name":"Research Center of Centre Hospitalier De L'universit\u00e9 De Montr\u00e9al  Montr\u00e9al Quebec 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