Abstract Background/Aims Health literacy has been deemed central to the prevention and control of noncommunicable diseases, including inflammatory arthritis (IA). Aim: To determine the association between health literacy, social determinants of health, and outcomes in people with IA. Methods Patients diagnosed with IA, recruited to the National Early Inflammatory Arthritis Audit (NEIAA) in England, were invited to complete an online survey (March-May 2024), comprising the Health Literacy Questionnaire (HLQ); Work Productivity and Activity Impairment questionnaire; Generalised Anxiety Disorder (GAD-2) and Patient Health Questionnaire (PHQ-2); questions on employment, education, treatment and self-reported disease activity. The HLQ has nine domains (Table 1). The survey was distributed to 3300 individuals, with responses matched with NEIAA records. Multivariable linear or logistic regression analyses adjusting for age, gender and other relevant covariates were conducted to determine associations between health literacy and outcomes. Results A total of 995 patients were included, median age 59 years (IQR 50-67), and 66% female. All HLQ domains were associated with high self-reported disease activity and greater anxiety and depression (GAD-2 and PHQ-2; Table 1). Low health literacy in HLQ domain 8 (FHI; OR 0.50 0.34, 0.71) and domain 9 (UHI; OR 0.56 0.38, 0.82) were associated with increased corticosteroid use and comorbidity burden. High health literacy in HLQ domain 8 (FHI; OR 1.41 1.04, 1.92) was associated with increased likelihood of employment. Low health literacy across most HLQ domains was associated with significantly greater absenteeism, presenteeism and work productivity loss. Outcomes for all analyses were unchanged after controlling for education as an additional covariate. Conclusion Low health literacy in IA is associated with poorer physical and mental health, worse work outcomes and greater comorbidity. Specifically, low health literacy in domains 8 (Ability to find good health information) and 9 (Understanding health information well enough to know what to do) were associated with increased likelihood of corticosteroid use, poor work outcomes and greater comorbidity burden. Access to and understanding health information may therefore be a target for interventions to improve these aspects. Using the unique depth of the NEIAA, this large study underscores the need to address health literacy in rheumatology care. Disclosure M. Dey: None. S. Norton: None. A. Cope: None. M.H. Buch: None. A. Bosworth: None. R. Osborne: None. J. Galloway: None. E. Nikiphorou: None.
Dey et al. (Wed,) studied this question.