David J Hunter1,2, Andrew J McLachlan3, Peter R Carroll2,3, Tom An Wakefield4, Rodney Stosic5. 1. Department of Rheumatology, University of Sydney, Camperdown, NSW, Australia. 2. Royal North Shore Hospital, St Leonards, NSW, Australia. 3. School of Pharmacy, Faculty of Medicine and Health University of Sydney, Camperdown, NSW, Australia. 4. FiftyFive5 Pty Ltd, Ultimo, NSW, Australia. 5. Bayer Australia Ltd, Pymble, NSW, Australia.
Abstract
BACKGROUND: Management guidelines encourage self-care in patients with symptomatic osteoarthritis (OA). This study investigated the relationship between health literacy (HL) and appropriateness of selection of self-care strategies in people with self-reported symptoms of OA. METHODS: Observational, national, online, demographically-representative, cross-sectional survey of adults (45-74 years). Eligibility "self-reported OA symptoms" was screened for using guideline-endorsed clinical criteria. Participants completed a custom-built questionnaire, which included validated scales for HL, pain intensity, sleep quality and OA function/disability. Management strategies were grouped into self-care activities, analgesics and complementary medicines, and analyses of appropriateness were based on pre-defined, evidence-based quality indicators. RESULTS: Of 6800 participants, 628 met the inclusion criteria and completed the survey. HL categorisation: low (100/628, 15.9%), moderate (317/628, 50.5%) and excellent (211/628, 33.6%). In the past 7 days, mean pain intensity (0-10 scale) was 3.11 (95%CI:3.06-3.16) and 71.7% (450/628) had not achieved adequate pain relief. In the past month, 54.1% (340/628) reported disrupted sleep. Participants managed their pain with multiple self-care activities (mean 1.44; 95%CI:1.32-1.57), analgesics (mean 1.74; 95%CI:1.60-1.88) and complementary medicines (mean 1.01; 95%CI:0.90-1.12). There was a statistically significant (p<0.001) interaction between HL and appropriateness of current management strategies (HL low, guideline-recommended management strategies less likely). Higher HL did not always translate into making appropriate pain management choices. CONCLUSION: Appropriate selection and use of evidence-based management options is critical for patients with OA to obtain the full benefits from their treatment. Knowledge about suitable choices for OA self-care is sub-optimal and future education should be tailored to different levels of HL. This article is protected by copyright. All rights reserved.
BACKGROUND: Management guidelines encourage self-care in patients with symptomatic osteoarthritis (OA). This study investigated the relationship between health literacy (HL) and appropriateness of selection of self-care strategies in people with self-reported symptoms of OA. METHODS: Observational, national, online, demographically-representative, cross-sectional survey of adults (45-74 years). Eligibility "self-reported OA symptoms" was screened for using guideline-endorsed clinical criteria. Participants completed a custom-built questionnaire, which included validated scales for HL, pain intensity, sleep quality and OA function/disability. Management strategies were grouped into self-care activities, analgesics and complementary medicines, and analyses of appropriateness were based on pre-defined, evidence-based quality indicators. RESULTS: Of 6800 participants, 628 met the inclusion criteria and completed the survey. HL categorisation: low (100/628, 15.9%), moderate (317/628, 50.5%) and excellent (211/628, 33.6%). In the past 7 days, mean pain intensity (0-10 scale) was 3.11 (95%CI:3.06-3.16) and 71.7% (450/628) had not achieved adequate pain relief. In the past month, 54.1% (340/628) reported disrupted sleep. Participants managed their pain with multiple self-care activities (mean 1.44; 95%CI:1.32-1.57), analgesics (mean 1.74; 95%CI:1.60-1.88) and complementary medicines (mean 1.01; 95%CI:0.90-1.12). There was a statistically significant (p<0.001) interaction between HL and appropriateness of current management strategies (HL low, guideline-recommended management strategies less likely). Higher HL did not always translate into making appropriate pain management choices. CONCLUSION: Appropriate selection and use of evidence-based management options is critical for patients with OA to obtain the full benefits from their treatment. Knowledge about suitable choices for OA self-care is sub-optimal and future education should be tailored to different levels of HL. This article is protected by copyright. All rights reserved.
Authors: Andrew J McLachlan; Peter R Carroll; David J Hunter; Tom A N Wakefield; Rodney Stosic Journal: Health Expect Date: 2022-01-08 Impact factor: 3.318