Limited health literacy tied to low knowledge on SLE

Limited health literacy among patients with systemic lupus erythematosus (SLE) contributes to lower knowledge about the disease, a study has shown. The Lupus Knowledge Assessment Test (LKAT) may be improved and used as a screening tool to identify those with knowledge gaps.

The authors recruited from an academic centre clinic SLE patients, who completed validated assessments of health literacy (Newest Vital Sign [NVS]) and numeracy (Numeracy Understanding in Medicine Instrument, Short Version [S-NUMI]).

Participants also completed the LKAT, which consists of four questions assessing SLE knowledge determined through consensus expert opinion for their wide applicability and importance related to self-management of the disease. Results were analysed using descriptive statistics and multivariable logistic regression modeling.

The SLE cohort included 125 patients, of whom 33 percent (32/96) had limited health literacy and 76 percent (65/85) had limited numeracy. Most of the participants (91 percent) correctly identified that hydroxychloroquine prevented SLE flares, but only a fourth (23 percent) correctly answered a numeracy question assessing which urine protein to creatinine (UPC) ratio was >1,000 mg/g.

The mean LKAT score was 2.7 out of 4.0. Limited health literacy, but not numeracy, correlated with lower knowledge about SLE as measured by the LKAT, even after adjustment for education.

“Further work is needed to improve patients’ understanding of proteinuria and investigate whether literacy-sensitive education can improve care,” the authors said.