Management guidelines encourage self-care in patients with symptomatic osteoarthritis (OA). This study investigated the relationship between health literacy (HL) and appropriateness of selection of self-care strategies in people with self-reported symptoms of OA.
Observational, national, online, demographically-representative, cross-sectional survey of adults (45-74 years). Eligibility "self-reported OA symptoms" was screened for using guideline-endorsed clinical criteria. Participants completed a custom-built questionnaire, which included validated scales for HL, pain intensity, sleep quality and OA function/disability. Management strategies were grouped into self-care activities, analgesics and complementary medicines, and analyses of appropriateness were based on pre-defined, evidence-based quality indicators.
Of 6800 participants, 628 met the inclusion criteria and completed the survey. HL categorisation: low (100/628, 15.9%), moderate (317/628, 50.5%) and excellent (211/628, 33.6%). In the past 7 days, mean pain intensity (0-10 scale) was 3.11 (95%CI:3.06-3.16) and 71.7% (450/628) had not achieved adequate pain relief. In the past month, 54.1% (340/628) reported disrupted sleep. Participants managed their pain with multiple self-care activities (mean 1.44; 95%CI:1.32-1.57), analgesics (mean 1.74; 95%CI:1.60-1.88) and complementary medicines (mean 1.01; 95%CI:0.90-1.12). There was a statistically significant (p<0.001) interaction between HL and appropriateness of current management strategies (HL low, guideline-recommended management strategies less likely). Higher HL did not always translate into making appropriate pain management choices.
Appropriate selection and use of evidence-based management options is critical for patients with OA to obtain the full benefits from their treatment. Knowledge about suitable choices for OA self-care is sub-optimal and future education should be tailored to different levels of HL.