Gorter, A.R. (Anne) (2021) The predictive value of health literacy on disease activity and medication use over time in rheumatoid arthritis patients. thesis, Medicine.
Full text available on request.Abstract
Background: Health literacy is increasingly recognized as a critical determinant of an individual’s health. The negative impact of limited health literacy on health outcomes has been proven in multiple fields of medicine. This study focusses on the direct impact of limited health literacy on disease activity and medication use in patients with rheumatoid arthritis. Gaining insight into the mechanisms of health literacy might help improve current treatment options and health outcomes. Method: In this single center, retrospective cohort study 108 rheumatoid arthritis patients, were divided into three health literacy groups; limited health literacy (n=21), sufficient health literacy (n=33) and good health literacy (n=54). This study then looked at potential differences between the health literacy groups. Patients were analyzed based on their disease activity, inflammation parameter (ESR) and medication use over a period of 12 months. Normally distributed data were analyzed using ANOVA and linear mixed modelling. Data that was not normally distributed was analyzed using Kruskall-Wallis and generalized mixed modelling. Results: A significant difference in DAS scores between the good health literacy group and limited health literacy group was found at baseline (p=0.004) and over the 12-month time period (p=0.007). ESR levels did not show a significant difference between the health literacy groups. Differences in medication use between the groups were observed. Patients with limited health literacy used more prednisolone (p=0.019) than either of the other two groups, while patients with sufficient health literacy used the highest number of conventional DMARDs compared to patients with good health literacy (p=0.008). Conclusion: Rheumatoid arthritis patients with limited health literacy show a higher level of disease activity and use a significantly higher number of prednisolone. Patients with sufficient health literacy use a higher number of conventional DMARDs than either of the other health literacy groups and might need more support from their health professionals in managing their health care. The causal pathway behind these findings is not entirely understood and needs to be explored.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Vonkeman, dr. H.E. and Klooster, dr. P.M. ten |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 10:03 |
| Last Modified: | 07 Jan 2022 10:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2991 |
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