Digital health literacy in patients with chronic kidney disease: a cross-sectional study

Background Chronic kidney disease (CKD) care is increasingly reliant on digital tools. However, diverse abilities among patients may create a digital divide, exacerbating disparities in health outcomes. Measuring digital health literacy is the first step towards gaining knowledge to develop targeted, patient-centred strategies. Due to a lack of available evidence, this study aimed to assess digital health literacy levels among patients with CKD.Methods A multicentre cross-sectional study was conducted between July 2024 - January 2025, enrolling CKD patients from three Nephrology Units in central and southern Italy. Data were collected through a questionnaire assessing: (I) sociodemographic data; (II) clinical variables; (III) digital health literacy, using the Health Literacy Population Survey 2019-Digital (HLS19-DIGI) tool; (IV) health information-seeking modalities and behaviours, and digital training.Results A total of 323 participants were enrolled (mean age 54.8 +/- 16.0 years). A 'problematic' level was found with regard to dealing with digital health information, and a 'sufficient' level was observed in interacting with digital health resources. Digital devices were used approximately one to three days per week. Older age and lower level of education were predictors of worse coping and interaction abilities, while these were higher among patients with better socio-economic status, without a caregiver, and who were physically active, and compliant with kidney disease medication and diet. Moreover, on the HLS19-DIGI, retired participants scored lower while digitally trained individuals scored higher. Both seeking information beyond what is provided by health professionals and prior digital training were predictors of more frequent use of digital devices for health.Conclusions Targeted interventions are warranted to promote digital health literacy and more frequent engagement with digital devices among CKD patients.