239 Prevalence of impaired health literacy in patients with rheumatoid arthritis and its association with medication understanding and patient outcomes

Grose-Hodge, Ellen; Scott, Ian; Dale, Nicola; Ryan, Sarah; Machin, Annabelle; Hider, Samantha

Abstract

Background: Managing long-term conditions like rheumatoid arthritis (RA) involves clinicians imparting information effectively in brief appointments, often supplemented with written information. Health literacy (HL), defined as the degree to which individuals can obtain, process and understand the basic health information they need to make health decisions, may affect medication understanding. We examined the prevalence of impaired HL in a cohort of patients attending an RA annual review clinic, and its impact on their understanding of RA medications and disease outcomes.

Methods: Consecutive RA patients attending an annual review clinic at two Staffordshire community hospitals were recruited to this cross-sectional study. A questionnaire captured HL using the Single Item Health Literacy Screener (SILS), asking how often you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy. A score ≥2 is a validated method to identify patients needing help reading health-related material. The questionnaire also captured information on patients’ understanding of their RA medications, if they felt they would benefit from updating their RA medication knowledge and anxiety and depression (PHQ-2/GAD-2). Fisher’s exact/t-tests compared differences between patients with and without impaired HL for categorical/continuous variables. Ethical approval was obtained (REC 15-WS-0063).

Results: Data from 153 RA patients were analysed (Table 1). The mean (SD) age was 66.9 (12.0) years and 103 (67%) were female. 12 (8%) had impaired HL. More patients with impaired HL felt they didn’t fully understand their RA medications (20% vs. 13%; P=0.64), but less felt they would benefit from updating their medication knowledge (42% vs. 59%; P=0.36). Patients with impaired HL had non-significant trends towards increased DAS28 and HAQ scores, more hospitalisations, and a greater prevalence of anxiety and depression.

Conclusion: In our cohort, approximately 1 in 10 RA patients had impaired HL, and 12% reported not understanding enough about their medications. This suggests care is needed when counselling patients about their DMARDs to ensure they fully understand the risks, benefits and when to withhold DMARD treatments.

Citation

Grose-Hodge, E., Scott, I., Dale, N., Ryan, S., Machin, A., & Hider, S. (2018, May). 239 Prevalence of impaired health literacy in patients with rheumatoid arthritis and its association with medication understanding and patient outcomes. Poster presented at British Society for Rheumatology Annual Conference 2018, The ACC & Exhibition Centre Liverpool, Liverpool, UK

• Presentation Conference Type: Poster
• Conference Name: British Society for Rheumatology Annual Conference 2018
• Conference Location: The ACC & Exhibition Centre Liverpool, Liverpool, UK
• Start Date: May 1, 2018
• End Date: May 3, 2018
• Deposit Date: Jun 26, 2023
• Publisher: Oxford University Press
• DOI: https://doi.org/10.1093/rheumatology/key075.463
• Keywords: Pharmacology (medical); Rheumatology
• Publisher URL: https://academic.oup.com/rheumatology/article/57/suppl_3/key075.463/4971365