Health Literacy and Appropriateness of Self‐Care and Pain Management in Osteoarthritis: An Understanding of the Patient's Perspective

Abstract

Objective. Management guidelines encourage self-care in patients with symptomatic osteoarthritis (OA). We undertook this study to investigate the relationship between health literacy (HL) and appropriateness of selection of self-care strategies in people with self-reported symptoms of OA.Methods. We conducted an online national observational, demographically representative, cross-sectional survey of adults (ages 45-74 years). The eligibility criterion of "self-reported OA symptoms" was screened for using guideline-endorsed clinical criteria. Participants completed a custom-built questionnaire that 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 predefined, evidence-based quality indicators.Results. Of 6,800 participants, 628 met the inclusion criteria and completed the survey. HL was categorized as follows: low (100 of 628, 15.9%), moderate (317 of 628, 50.5%), and excellent (211 of 628, 33.6%). In the past 7 days, mean pain intensity (0-10 scale) was 3.11 (95% confidence interval [95% CI] 3.06-3.16), and 71.7% of participants (450 of 628) had not achieved adequate pain relief. In the past month, 54.1% (340 of 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 suboptimal, and future education should be tailored to different levels of HL.

Osteoarthritis management: Does the pharmacist play a role in bridging the gap between what patients actually know and what they ought to know? Insights from a national online survey

“…A significantly higher proportion of females were categorized as having high health literacy than were males (Table 1). The primary endpoint analysis showed evidence of a statistically significant interaction between health literacy and overall appropriateness of management strategies ( p < .001) 18 …”

“…Health literacy has the potential to influence the appropriateness of self‐care strategies and could therefore impact outcomes achievable via patient‐directed OA management 8,9,50 . The primary endpoint analysis from the study highlights this to be of particular relevance 18 . Knowledge about suitable choices of analgesics for joint pain management was suboptimal.…”

“…The methods have been published in detail elsewhere. 18 Briefly, a national online survey was conducted amongst adults aged 45–74 years, currently residing in Australia, with self‐reported symptoms of OA. The cohort was derived from an Australian accredited research‐only online panel (Dynata).…”

“… 11 , 17 A recent survey, conducted amongst adults with self‐reported symptoms of OA, investigated the participants' perceptions of pain and their use of self‐management strategies for pain relief. 18 The study reported a significant association between health literacy and the appropriate selection of recommended self‐management strategies and highlighted participants suboptimal knowledge about suitable pain relief choices. Recognizing that the pharmacist is well placed to provide counselling to help improve patients' knowledge about and correct use of medicines, 19 , 20 this paper explores this study, focusing on the findings of relevance to the community pharmacist.…”

“…However, data exploring this issue from the perspective of the patient are limited 11,17 . A recent survey, conducted amongst adults with self‐reported symptoms of OA, investigated the participants' perceptions of pain and their use of self‐management strategies for pain relief 18 . The study reported a significant association between health literacy and the appropriate selection of recommended self‐management strategies and highlighted participants suboptimal knowledge about suitable pain relief choices.…”