Limited health literacy and numeracy are related to poorer patient-reported outcomes and increased disease activity in systemic lupus erythematosus (SLE). However, it was unclear which variables may modulate this relationship. Therefore, for a study, researchers wanted to determine if there was a link between health literacy and SLE knowledge.
SLE patients were selected from a clinic at an academic facility. Validated evaluations of health literacy (Newest Vital Sign [NVS]; n=96) and numeracy (Numeracy Understanding in Medicine Instrument, Short Version [S-NUMI]; n=85) were administered to participants. They also took the Lupus Knowledge Assessment Test (LKAT), which consists of four questions that measure SLE knowledge and were chosen based on expert consensus for their broad application and usefulness in illness self-management. The findings were analyzed using descriptive statistics and multivariable logistic regression modeling.
In the SLE cohort (n=125), 33% (32/96) had poor health literacy, and 76% (65/85) had poor numeracy. The majority of participants (91%) correctly recognized that hydroxychloroquine reduced SLE flares; however, only 23% correctly answered a numeracy question determining which urine protein to creatinine (UPC) ratio was more than 1,000 mg/g. The average LKAT score was 2.7 out of a possible 4.0. Even after controlling for schooling, low health literacy, but not numeracy, was linked with lower knowledge of SLE as measured by the LKAT.
Patients with SLE with inadequate health literacy had less understanding of the disease. The LKAT might be improved and used to identify patients with knowledge gaps as a screening tool. More research is needed to understand patients’ proteinuria better and see if literacy-sensitive teaching might enhance care.