Value for Clinicians
The session’s second speaker was Mark Bakker, PhD candidate in health literacy, Maastricht University, Netherlands, and his presentation focused on the value of health literacy information to clinicians.
Dr. Bakker described work that he and his colleagues performed to explore longitudinal associations between health literacy profiles, disease activity, and medication prescribing patterns in patients with rheumatoid arthritis (RA).
In the study, 108 patients with RA were asked to complete the Health Literacy Questionnaire and were then categorized into one of three groups: several health literacy limitations; some health literacy limitations; or good health literacy. Patients with good health literacy were found to have significantly lower disease activity than those with several health literacy limitations (DAS-ESR 2.4 vs. 3.1). In addition, patients with good health literacy were most often prescribed biologic disease-modifying anti-rheumatic drug (bDMARD) therapy, whereas patients with several health literacy limitations were more often prescribed prednisolone than the other groups.2 These findings indicate that health literacy may be associated with disease activity and may influence prescribing patterns by doctors who take care of these patients.
Dr. Bakker also referenced the work of Dr. Osborne and colleagues with respect to Ophelia (OPtimising HEalth LIterAcy) Victoria, a partnership between two universities, eight service organizations and the government of Victoria, Australia, which sought to identify and respond to health literacy issues for people with chronic conditions. The program asked two main questions: 1) What are the health literacy strengths and weaknesses of clients of participating sites; and 2) how do sites interpret and respond to these to achieve positive health and equity outcomes for their clients?
The process involved three phases, the first being a needs assessment, the second involving frontline staff and management creating intervention plans to respond to local needs, and the third being a trial of interventions within each site to improve limitations to service access and/or health outcomes.3
Reflecting on this and other work, Dr. Bakker said his key takeaways are that diversity in health literacy needs must be considered to improve the impact of services and outcomes and that impactful health literacy actions are rooted in local context and generated by local wisdom.
Telehealth Considerations
The third speaker, Annette de Thurah, PhD, MPH, professor, Department of Rheumatology and Institute of Clinical Medicine, Aarhus University, Denmark, discussed how rheumatologists should and can be knowledgeable about health literacy when implementing telehealth services. She noted that barriers exist to the effective use of telehealth, including lack of training on telehealth activities for providers, issues of digital health literacy and digital safety, and lack of face-to-face contact as part of the doctor-patient relationship. However, telehealth also offers benefits in the form of accessibility, saving time and travel for patients, and providing flexibility to services rendered.
