The impact of health literacy: associations with disease activity and medication prescription in patients with rheumatoid arthritis

Anne Gorter, Mark M Bakker*, Peter M Ten Klooster, Annelies Boonen, Harald E Vonkeman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
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Abstract

Objective: The aim of this study was to explore the longitudinal associations between health literacy profiles and disease activity and medication prescription in patients with rheumatoid arthritis (RA).
Methods: Patients with RA who previously completed the Health Literacy Questionnaire (HLQ) and were assigned one of ten distinct health literacy profiles based on cluster analysis were further aggregated into three groups: 'several health literacy limitations', 'some health literacy limitations' and 'good health literacy'. Linear mixed modelling (LMM) was used to analyse the association between health literacy groups and disease activity over the course of 1 year. χ2 tests and logistic regression analyses were used to compare medication prescriptions between the groups.
Results: 108 patients with RA were included. LMM showed a significant effect of health literacy group on disease activity over time (p= 0.010). Patients with 'good health literacy' had significantly lower disease activity over time (DAS28-ESR = 2.4) than patients with 'several health literacy limitations' (DAS28-ESR = 3.1), independent of age, gender and education level. Patients with 'good health literacy' were most often prescribed a bDMARD (50%), whereas patients with 'some health literacy limitations' more commonly received a csDMARD only (72.7%, OR 4.24), and patients with 'several health literacy limitations' were more often prescribed prednisolone (52.4%, OR 3.56).
Conclusion: Significant differences in longitudinal disease activity and medication prescription were observed between groups with different health literacy levels. These results stress the importance of insight into the role of health literacy in treatment and outcomes in patients with rheumatoid arthritis.
Original languageEnglish
Pages (from-to)3409-3415
Number of pages7
JournalRheumatology
Volume62
Issue number10
Early online date24 Feb 2023
DOIs
Publication statusPublished - Oct 2023

Keywords

  • disease activity
  • health inequalities
  • health literacy
  • medication prescription
  • rheumatoid arthritis

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