Original Article

HSS Journal ®

, Volume 9, Issue 1, pp 42-49

First online:

The Relationship Among Health Literacy, Health Knowledge, and Adherence to Treatment in Patients with Rheumatoid Arthritis

  • Patricia QuinlanAffiliated withHospital for Special Surgery Email author 
  • , Kwanza O. PriceAffiliated withHospital for Special Surgery
  • , Steven K. MagidAffiliated withHospital for Special SurgeryWeill Cornell University Medical College
  • , Stephen LymanAffiliated withHospital for Special Surgery
  • , Lisa A. MandlAffiliated withHospital for Special SurgeryWeill Cornell University Medical College
  • , Patricia W. StoneAffiliated withCenter for Health Policy, Columbia University School of Nursing

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Abstract

Background

Patients with poor health literacy often lack the knowledge needed to manage their treatment.

Objective

The aim of this cross-sectional study is to determine whether health literacy is a predictor of health knowledge and/or adherence to medication treatment in patients with rheumatoid arthritis.

Method

The study was completed in an urban, outpatient rheumatology setting. Health literacy was measured using the Test of Functional Health Literacy in Adults. The Arthritis Knowledge Questionnaire was modified to measure medication specific health knowledge, and the Morisky Medication Adherence scale was used to measure adherence. Researchers used regression analyses to determine if health literacy was a predicator of knowledge and/or adherence.

Results

Participants (N = 125) had high mean health literacy scores. The average medication knowledge score was 0.73. Adherence to medication regimen was 0.84. Controlling for patient covariates, health literacy was positively associated with education, race, and age. In adjusted analyses, health literacy was a significant predictor of health knowledge but not adherence. Race, neighborhood income, and confidence with contacting provider about medications were predictors of adherence.

Conclusion

Study findings indicate that health literacy is independently associated with medication knowledge but not medication adherence in patients with rheumatoid arthritis. These results provide useful information for planning initiatives to support individuals with disease self-management.

Keywords

health literacy health knowledge adherence to treatment