Association of health literacy with disease outcomes in inflammatory arthritis: a systematic review
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objectives
This study aims to conduct a systematic literature review (SLR) to summarise associations between health literacy and inflammatory arthritis (IA) outcomes, to inform management.
Methods
Inclusion criteria were adults with IA; studies assessing health literacy or interventions targeting health literacy; observational and qualitative studies, randomised controlled trials. Searches were performed using MeSH headings for health literacy and IA. Data were extracted on demographics, health literacy assessment and relevant outcomes, grouped into themes using vote-counting.
Results
Of 3087 identified articles, 29 were included. The total number of participants across all studies was 16,402, comprising mostly females, with a mean age of 46 to 70 years. Ethnicity was reported in 13 studies; most participants were Caucasian. The most frequently reported IA was rheumatoid arthritis. Health literacy measures included: Test of Functional Health Literacy in Adults (n = 13); Single Item Literacy Screener (n = 10); Rapid Estimate of Adult Literacy in Medicine (n = 6); Health Literacy Questionnaire (n = 2). Six main associations were identified with low health literacy: higher disease activity; more disability; more mental health symptoms (including depression and anxiety); higher healthcare use; lower medication adherence; lower use of internet, telehealth and technology.
Conclusions
In people with IA, low health literacy is generally associated with worse outcomes including higher disease activity, mental health symptoms and disability, higher healthcare use, lower medication adherence, and lower use of technology. This is the first SLR to synthesise associations between health literacy and outcomes in IA. Our findings should inform policy and resource allocation and improve the quality of care for patients with IA and low health literacy.
This study aims to conduct a systematic literature review (SLR) to summarise associations between health literacy and inflammatory arthritis (IA) outcomes, to inform management.
Methods
Inclusion criteria were adults with IA; studies assessing health literacy or interventions targeting health literacy; observational and qualitative studies, randomised controlled trials. Searches were performed using MeSH headings for health literacy and IA. Data were extracted on demographics, health literacy assessment and relevant outcomes, grouped into themes using vote-counting.
Results
Of 3087 identified articles, 29 were included. The total number of participants across all studies was 16,402, comprising mostly females, with a mean age of 46 to 70 years. Ethnicity was reported in 13 studies; most participants were Caucasian. The most frequently reported IA was rheumatoid arthritis. Health literacy measures included: Test of Functional Health Literacy in Adults (n = 13); Single Item Literacy Screener (n = 10); Rapid Estimate of Adult Literacy in Medicine (n = 6); Health Literacy Questionnaire (n = 2). Six main associations were identified with low health literacy: higher disease activity; more disability; more mental health symptoms (including depression and anxiety); higher healthcare use; lower medication adherence; lower use of internet, telehealth and technology.
Conclusions
In people with IA, low health literacy is generally associated with worse outcomes including higher disease activity, mental health symptoms and disability, higher healthcare use, lower medication adherence, and lower use of technology. This is the first SLR to synthesise associations between health literacy and outcomes in IA. Our findings should inform policy and resource allocation and improve the quality of care for patients with IA and low health literacy.
Date Issued
2026-01-01
Date Acceptance
2025-08-17
Citation
Annals of the Rheumatic Diseases, 2026, 85 (1), pp.195-209
ISSN
0003-4967
Publisher
Elsevier BV
Start Page
195
End Page
209
Journal / Book Title
Annals of the Rheumatic Diseases
Volume
85
Issue
1
Copyright Statement
© 2025 The Author(s). Published by Elsevier B.V. on behalf of European Alliance of Associations for Rheumatology (EULAR). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
License URL
Identifier
10.1016/j.ard.2025.08.018
Publication Status
Published
Date Publish Online
2025-09-11