P182 Health literacy and gout characteristics in a primary care cohort
Authors: Watson Lorraine , Protheroe Joanne , Mallen Christian D , Muller Sara , Roddy Edward 
Published: April 2022

Abstract

Background/Aims
Gout is the most common inflammatory arthritis, affecting 2.5% of the UK population. It is often suboptimally managed, despite the availability of effective urate-lowering therapy. Health literacy has been conceptualised to include dimensions relating to ‘the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion settings’. The objective of this study was to examine the cross-sectional associations between health literacy and gout characteristics.

Methods
In a prospective 5-year cohort study, adults living with gout registered with 20 general practices, who had consulted their GP about gout or been prescribed allopurinol or colchicine in the preceding two years were mailed a questionnaire. This cross-sectional analysis used data from the 4-year follow-up time-point only. Health literacy was assessed using the Single Item Literacy Screener (SILS). Poor health literacy was defined as answering ‘sometimes’, ‘often’ or ‘always’ to the question ‘How often do you need to have someone help you when you read instructions, pamphlets, or other written material from your doctor or pharmacy?’ Multiple logistic regression was used to obtain adjusted odds ratios for the associations between poor health literacy and individual gout characteristics (frequency of flares, age of gout onset, history of oligo/polyarticular flares, allopurinol use, allopurinol dose, serum urate level) with 95% confidence intervals and adjustment for age, sex, deprivation and attendance at further education.

Results
Five hundred and fifty-one participants responded to the questionnaire at four years (adjusted response 63.5%). Mean (SD) age was 64.4 (11.2) years and 498 (90.4%) were male. One hundred and sixty-three (30.1%) participants reported ≥2 flares in the previous 12 months. Fifty-one (9.4%) participants had poor health literacy. Poor health literacy was associated with more frequent flares (≥2 flares in the last 12 months; adjusted OR 4.10; 95%CI 2.04, 8.19; compared with no flares) and having a history of oligo/polyarticular flares (adjusted OR 1.93; 95%CI 1.06, 3.55), after adjustment for age, sex, deprivation and attendance at further education. No associations between other gout characteristics and health literacy were identified in the adjusted analysis.

Conclusion
Frequent flares and a history of oligo/polyarticular flares were associated with poor health literacy in people with gout in primary care. Our findings provide further evidence to counter the common misconception that gout is a ‘rich man’s disease’ and highlight the importance of considering health literacy when providing information and education to all people with gout.

Disclosure
L. Watson: Grants/research support; Lorraine Watson is funded by the National Institute for Health Research (NIHR) School for Primary Care Research. J. Protheroe: None. C.D. Mallen: Grants/research support; Christian Mallen is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration West Midlands, and the NIHR School for Primary Care Research, The School of Medicine as received funding from BMS for a non-pharmacological AF screening trial. S. Muller: Grants/research support; Sara Muller is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration West Midlands. E. Roddy: None.