The role of health literacy in clinical, treatment, and work-related outcomes in people with inflammatory arthritis in England: a cross-sectional study
Authors' conclusion
Lower health literacy is associated with poorer physical and mental health, poorer work outcomes, and greater comorbidity burden in people with inflammatory arthritis.
Study context
- Population
- Patients with confirmed inflammatory arthritis enrolled in the National Early Inflammatory Arthritis Audit (NEIAA), England657 (66%) female
- Participants
- 995 patients
- Exposure
- Associations of health literacy (nine-domain Health Literacy Questionnaire) with clinical, mental health and work-related outcomes
- Outcome
- Main outcomes: self-reported disease activity, employment status, depression, Rheumatic Disease Comorbidity Index and corticosteroid use
Methodological detailsmultivariable regression adjusting for age, sex and other relevant covariates, online survey matched with NEIAA records, People with lived experience of RA involved in design and conduct
- Multivariable regression adjusting for age, sex and other relevant covariates
- Online survey matched with NEIAA records
- People with lived experience of RA involved in design and conduct
Main finding
As reported in the abstract
Associations of health literacy domains with outcomes
- Disease activity: sufficient information to manage own health, β
- −17.04 (−20.69 to −13.39) (95% CI)
- Disease activity: ability to find good health information, β
- −12.40 (−15.60 to −9.19) (95% CI)
- Disease activity: understanding health information well enough to know what to do, β
- −13.23 (−16.63 to −9.84) (95% CI)
- Depression: sufficient information to manage own health, β
- −0.93 (−1.13 to −0.74) (95% CI)
- Depression: social support for health, β
- −0.89 (−1.08 to −0.71) (95% CI)
- Comorbidity burden: ability to find good health information, β
- −0.10 (−0.19 to −0.01) (95% CI)
- Comorbidity burden: understanding health information well enough to know what to do, β
- −0.16 (−0.25 to −0.06) (95% CI)
- Corticosteroid use: ability to find good health information, RR
- 0.56 (0.43 to 0.73)
- Corticosteroid use: understanding of health information, RR
- 0.62 (0.45 to 0.84)
Observational data: associations, not effects.
Original publication
The role of health literacy in clinical, treatment, and work-related outcomes in people with inflammatory arthritis in England: a cross-sectional study. Lancet Rheumatol. Published 28 May 2026. doi:10.
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