Improving health literacy for patients with psoriasis may lead to improved self-management skills, self-efficacy, and quality of life, according to a study published in the British Journal of Dermatology.
Researchers of this cross-sectional study evaluated the relationship between health literacy, psoriasis severity, medical comorbidities, psoriasis knowledge, quality of life in relation to dermatology, and self-efficacy in patients with moderate to severe psoriasis who participated in the Norwegian Climate Helio therapy program. Questionnaire packets were mailed to 1275 adults who participated in the therapy program between 2011 and 2017.
Of the 825 patients (mean age, 53.3 years) who completed the questionnaires, 47.4% were women, 14.3% were using biological medicines, 35.5% had a history of depression, 66.8% reported joint pain. In regards to the first 5 scales in the health literacy questionnaire, “actively managing my health” (mean score=2.78, SD=0.51) had the highest score and “appraisal of health information” (mean score=2.54, SD=0.54) had the lowest score. In regards to the last 4 scales in the health literacy questionnaire, “understanding health information well enough to know what to do” (mean score=3.56, SD=0.62) had the highest score and “navigating the healthcare system” (mean score=3.10, SD=0.71) had the lowest score.
After bivariate associations were calculated for demographic data, men had a lower score on “actively managing my health” (β=0.1; P =.01), while education level predicted “ability to find good health information” (β=-0.13; P =.01) and “ability to understand health information well enough to know what to do” (β=0.12; P =.01). After bivariate associations were calculated for clinical variables, fewer comorbidities were related to higher scores in “having social support for health” (-β=0.12; P =.01) and “ability to navigate the healthcare system” (-β=0.10; P =.001). Self-efficacy was significantly associated with all health literacy scales, the Dermatology Life Quality Index significantly predicted higher health literacy scores in all scales other than “actively managing health” and “critical appraisal”, and psoriasis knowledge significantly predicated higher health literacy scores in all scales other than “actively managing health” and “social support for health.”
Limitations of this study include the questionnaires only being paper-based and in Norwegian, which could limit response rates, and that all answers are self-reported without clinical verification. Further research is needed to analyze the mechanisms that are needed for an effective intervention program.
The researchers concluded that “improving [health literacy] may be a useful strategy for reducing disparities in self-management skills, self-efficacy and [quality of life]” in patients with moderate to severe psoriasis.
Larsen MH, Strumse YAS, Borge CR, Osborne R, Andersen MH, Wahl AK. Health literacy – a new piece of the puzzle in psoriasis care? [published online December 31, 2018]. Br J Dermatol. doi: 10.1111/bjd.17595