Investigating Health Literacy in Systemic Lupus Erythematosus: a Descriptive Review
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AUTOIMMUNITY (TK TARRANT, SECTION EDITOR)
Investigating Health Literacy in Systemic Lupus Erythematosus: a Descriptive Review Mithu Maheswaranathan 1 & Sarah Cantrell 2 & Amanda M. Eudy 1 & Jennifer L. Rogers 1 & Megan E. B. Clowse 1 & Susan N. Hastings 3,4 & Stacy Cooper Bailey 5 Accepted: 26 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Inadequate health literacy is common among American adults, but little is known about the impact of health literacy in rheumatic diseases. The purpose of this article is to review studies investigating health literacy and its association with clinical outcomes in systemic lupus erythematosus (SLE). Recent Findings Several validated health literacy measures have been examined in SLE patients. Low health literacy is associated with worse patient-reported outcomes and lower numeracy with higher disease activity. Two studies found no association of low health literacy with medication adherence. One randomized controlled trial tested a medication decision aid among patients with low health literacy. Summary We found a paucity of studies exploring health literacy in SLE. Low health literacy is associated with worse patientreported outcomes and limited numeracy with higher disease activity in SLE. Further studies are needed exploring the impact of low health literacy on clinical outcomes and the effectiveness of literacy-sensitive interventions. Keywords Systemic lupus erythematosus . Health literacy . Numeracy . Lupus
Introduction Health literacy is defined as the degree to which individuals have “the capacity to obtain, process, and understand basic health information and services needed to make appropriate
This article is part of the Topical Collection on Autoimmunity * Mithu Maheswaranathan [email protected] 1
Division of Rheumatology & Immunology, Duke University Department of Medicine, Durham, NC, USA
2
Duke Medical Center Library & Archives, Duke University School of Medicine, Durham, NC, USA
3
Departments of Medicine & Population Health Sciences and Center for the Study of Aging, Duke University, Durham, NC, USA
4
Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
5
Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
health decisions” [1]. Adequate health literacy is required to complete tasks like reading and comprehending prescription bottles, understanding health-related materials, using medical tools like a thermometer or blood pressure cuff, and managing medications. Low or inadequate health literacy is associated with poor health outcomes including increased hospitalizations, higher readmission rates, greater use of emergency care, poorer medication adherence, and worse disease activity [2–8]. Low health literacy has a substantial cost burden and is estimated to cost the US economy between $106 and $238 billion USD annually [9]. By better unders
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