Health Literacy Rates in a Population of Patients with Rheumatoid Arthritis in Southwestern Ontario

Zhaowei Gong; Sara L Haig; Janet E Pope; Sherry Rohekar; Gina Rohekar; Nicole G H LeRiche; Andrew E Thompson

doi:10.3899/jrheum.141509

Health Literacy Rates in a Population of Patients with Rheumatoid Arthritis in Southwestern Ontario

J Rheumatol. 2015 Sep;42(9):1610-5. doi: 10.3899/jrheum.141509. Epub 2015 Aug 1.

Authors

Zhaowei Gong¹, Sara L Haig¹, Janet E Pope¹, Sherry Rohekar¹, Gina Rohekar¹, Nicole G H LeRiche¹, Andrew E Thompson²

Affiliations

¹ From the Department of Medicine, Division of Rheumatology, Western University, and the Rheumatology Centre, St. Joseph's Health Care, London, Ontario, Canada.Z. Gong, MD, Medical Student; S.L. Haig, MD, Adjunct Professor of Medicine; J.E. Pope, MD, Professor of Medicine; S. Rohekar, MD, Associate Professor of Medicine; G. Rohekar, MD, Assistant Professor of Medicine; N.G. LeRiche, MD, Associate Professor of Medicine; A.E. Thompson, MD, MHPE, FRCPC, Associate Professor of Medicine, Western University, Rheumatology Centre, St. Joseph's Health Care.
² From the Department of Medicine, Division of Rheumatology, Western University, and the Rheumatology Centre, St. Joseph's Health Care, London, Ontario, Canada.Z. Gong, MD, Medical Student; S.L. Haig, MD, Adjunct Professor of Medicine; J.E. Pope, MD, Professor of Medicine; S. Rohekar, MD, Associate Professor of Medicine; G. Rohekar, MD, Assistant Professor of Medicine; N.G. LeRiche, MD, Associate Professor of Medicine; A.E. Thompson, MD, MHPE, FRCPC, Associate Professor of Medicine, Western University, Rheumatology Centre, St. Joseph's Health Care. [email protected].

PMID: 26233510
DOI: 10.3899/jrheum.141509

Abstract

Objective: To determine the rate of low health literacy in the rheumatoid arthritis (RA) population in southwestern Ontario.

Methods: For the study, 432 patients with RA were contacted, and 311 completed the assessment. The health literacy levels of the participants were estimated using 4 assessment tools administered in the following order: the Single Item Literacy Screener (SILS), the Medical Term Recognition Test (METER), the Rapid Estimate of Adult Literacy in Medicine (REALM), and the Shortened Test of Functional Health Literacy in Adults (STOFHLA).

Results: The rates of low literacy as estimated by STOFHLA, REALM, METER, and SILS were 14.5%, 14.8%, 14.1%, and 18.6%, respectively. All 4 assessment tools were statistically significantly correlated. STOFHLA, REALM, and METER were strongly correlated with each other (r = 0.59-0.79), while SILS only demonstrated moderate correlations with the other assessment tools (r = 0.33-0.45). Multiple linear regression and binary logistic regression analyses revealed that low levels of education and a lack of daily reading activity were common predictors of low health literacy. Using a non-English primary language at home was found to be a strong predictor of low health literacy in STOFHLA, REALM, and METER. Male sex was found to be a significant predictor of poor performance in REALM and METER, but not STOFHLA.

Conclusion: Low health literacy is an important issue in the southwestern Ontario RA population. About 1 in 7 patients with RA may not have the necessary skills to become involved in making decisions regarding their personal health. Rheumatologists should be aware of the low health literacy levels of patients with RA and should consider identifying patients at risk of low health literacy.

Keywords: HEALTH LITERACY; ONTARIO; RHEUMATOID ARTHRITIS.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Aged
Arthritis, Rheumatoid*
Health Knowledge, Attitudes, Practice*
Health Literacy*
Humans
Male
Middle Aged
Ontario
Physician-Patient Relations
Sex Factors
Surveys and Questionnaires