Health literacy and gout characteristics in a primary care cohort

Objectives To examine the cross-sectional association between health literacy and gout characteristics.Methods In a primary care cohort of adults living with gout, the prevalence of poor health literacy was defined using the Single-Item Literacy Screener (SILS). Multiple logistic regression was used to obtain adjusted odds ratios (ORs) for the cross-sectional associations between health literacy and individual gout characteristics (frequency of flares, age at gout onset, history of oligo-/polyarticular flares, allopurinol use, allopurinol dose and serum urate level) with 95% CIs and adjustment for age, sex, deprivation and further education.Results Of 551 participants [mean age 54.4 years (s.d. 11.2), 498 (90.4%) male], 163 (30.1%) reported two or more flares in the previous 12 months. Fifty-one (9.4%) had poor health literacy. Poor health literacy was associated with having two or more flares in the preceding 12 months [adjusted OR 4.10 (95% CI 2.04, 8.19)] and a history of oligo-/polyarticular flares [OR 1.93 (95% CI 1.06, 3.55)]. No associations were identified between health literacy and age at gout onset [OR 0.99 (95% CI 0.96, 1.01)], allopurinol use [OR 0.88 (95% CI 0.46, 1.65)] or dose [OR 1.00 OR (95% CI 1.00, 1.00)] or serum urate [most recent serum urate OR 1.0 (95% CI 1.00, 1.00)].Conclusions Frequent flares and a history of oligo-/polyarticular flares were associated with poor health literacy. Since health literacy is an important determinant of health outcomes, it is important to consider health literacy when providing information and education to people with gout. What does this mean for patients?Gout is a common type of arthritis that affects 1 in 40 people. It is caused by too much urate in the body, which can cause small, sharp crystals to form in and around joints. These crystals can cause gout flares where the joint is extremely painful and swollen. Gout is often poorly managed, despite there being medication that can treat gout and prevent flares in the long term. Some people struggle to understand and use information about their health. This is called poor health literacy. We compared people with gout who had poor health literacy with people who did not have poor health literacy. We found that people with poor health literacy had gout flares more often and were more likely to have flares affecting more than one joint than people without poor health literacy. Struggling to understand and use health information could make it difficult for people to manage their gout. This research highlights the importance of healthcare professionals thinking about health literacy when giving information and education to people with gout.