Knowledge is Power for RA

Rheumatoid arthritis patients with low health literacy had lower functional status than those with higher health literacy

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When it comes to dealing with chronic diseases like rheumatoid arthritis, being able to understand the health information you receive from doctors can make a big difference in effective disease management.

A recent study found that rheumatoid arthritis (RA) patients with lower health literacy (ability to understand health information) had significantly lower functional status than those with higher health literacy.

The study authors noted that this result may be due to patients with lower health literacy not taking their medications as instructed, but more research is needed to confirm this possibility.

"Speak with your doctor about appropriate treatment options for RA."

This study was led by Liron Caplan, MD, PhD, with the Denver Veterans Affairs Medical Center in the Division of Rheumatology at the University of Colorado School of Medicine. The research team examined the relationship between health literacy and functional status in patients with rheumatoid arthritis.

Health literacy is defined as the degree to which a person can receive, process and understand basic health information to make appropriate health decisions.

The study involved 6,052 RA patients in the National Data Bank for Rheumatic Diseases.

Health literacy was measured by asking participants two questions. The first question was, "How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy?" Participants who responded with "often" or "always" were considered to have low health literacy.

The second question was, "How confident are you filling out medical forms by yourself?" Participants who responded with "not at all" and "a little bit" were considered to have limited health literacy.

Functional status was determined using the Health Assessment Questionnaire-Disability Index (HAQ), which listed several different activities, including dressing and eating, and participants had to report the level of assistance they needed to complete each activity. Possible scores ranged from 0 to 3, with higher scores indicating poorer functional status.

Several factors that could influence functional status were taken into account, including age, sex, ethnic origin, annual income, education level, vision, social support, medication use and presence of other chronic conditions.

The researchers found that low health literacy was associated with a 0.376-unit increase on the HAQ for functional status, compared to patients with higher health literacy.

Health literacy was found to be more strongly associated with functional status than use of certain medications, smoking history and biological therapy treatments. Low health literacy was also associated with poorer self-reported adherence to rheumatoid arthritis medications.

The study authors suggested that low health literacy may be connected with worse functional status because these patients may not be fully adhering with medication recommendations. They noted, however, that more research is needed to confirm this theory.

This article has been accepted for publication and will be published in an upcoming issue of Arthritis Care & Research.

The study authors did not report any competing interests.

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Review Date: 
September 13, 2013
Last Updated:
September 13, 2013