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Addressing health literacy needs in rheumatology: which patient health literacy profiles need the attention of health professionals?

Bakker, M.M., Putrik, P., Rademakers, J., Laar, M. van de, Vonkeman, H., Kok, H., Voorneveld-Nieuwenhuis, H., Ramiro, S., Wit, M. de, Buchbinder, R., Batterham, R., Osborne, R.H., Boonen, S. Addressing health literacy needs in rheumatology: which patient health literacy profiles need the attention of health professionals? Arthritis Care and Research: 2021, 73(1), 100-109
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Objectives
To identify and describe health literacy profiles of patients with rheumatic diseases and explore whether the identified health literacy profiles can be generalized to a broader rheumatology context.

Methods
Patients with rheumatoid arthritis, spondyloarthritis and gout from three hospitals in different regions in the Netherlands completed the Health Literacy Questionnaire (HLQ). Hierarchical cluster analysis was used to identify patients’ health literacy profiles based on nine HLQ domains. A multinomial regression model with the identified health literacy profiles as the dependent variable was fitted to assess whether patients with a given disease type or attending a given hospital were more likely to belong to a specific profile.

Results
Among 895 participating patients, lowest mean HLQ domain scores (indicating most difficulty) were found for “Critical appraisal”, “Navigating the health system” and “Finding good health information”. The ten identified profiles revealed substantial diversity in combinations of strengths and weaknesses. While 42% of patients scored moderate to high on all nine domains (profiles 1 and 3), another 42% of patients (profiles 2, 4, 5 and 6) clearly struggled with one or several aspects of health literacy. Notably, 16% (profiles 7 to 10) exhibited difficulty across a majority of health literacy domains. The probability of belonging to one of the profiles was independent of hospital attended or type of rheumatic disease.

Conclusion
Ten distinct health literacy profiles were identified among patients with rheumatic diseases, independent of disease type and treating hospital. These profiles can be used to facilitate health literacy intervention development in rheumatology.