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OP0278-HPR THE RELATIONSHIP BETWEEN HEALTH LITERACY AND TREATMENT STATUS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS WHO ACHIEVED LUPUS LOW DISEASE ACTIVITY STATE: THE TRUMP2-SLE PROJECT

2023; BMJ; Linguagem: Inglês

10.1136/annrheumdis-2023-eular.1000

1468-2060

Ken‐ei Sada, Yoshia Miyawaki, K. Shidahara, Shoichi Nawachi, Yukitoshi Katayama, Yosuke Asano, Keigo Hayashi, Eric Katsuyama, Takayuki Katsuyama, Masashi Narazaki, Yoshinori Matsumoto, Nao Oguro, Yuichi Ishikawa, Nodoka Sakurai, Chiharu Hidekawa, Ryusuke Yoshimi, Dai Kishida, Takanori Ichikawa, Yasuhiro Shimojima, Noriaki Kurita, Nobuyuki Yajima, Shunichi Fukuhara,

Systemic Lupus Erythematosus Research

Background Although the relationship between health literacy and treatment outcome has been reported in certain illnesses[1,2], it remains unclear how health literacy affects treatment selection. Objectives This study aims to determine the relationship between health literacy and treatment status in patients with systemic lupus erythematosus (SLE) who have achieved a low disease activity state (LLDAS). Methods A cross-sectional study was conducted on 266 SLE patients who had achieved LLDAS, registered in the TRUMP[2]-SLE study[3], an ongoing multicenter cohort study conducted at five academic centers in Japan. The main exposure was the health literacy (scores 0-56) of the enrolled patients, as measured by the 14-item Communicative Critical Health Literacy Scale (FCCHL). The primary outcomes were daily glucocorticoid dose, hydroxychloroquine (HCQ) use, and immunosuppressant use. A secondary outcome was chronic damage measured by Systemic Lupus International Collaborating Clinics-Damage Index (SLICC-DI). Odds ratios (ORs) to assess the relationship between health literacy and treatment status were estimated with adjustment for confounders (age, sex, income, education, disease duration, and SLICC-DI). Results The median age of the patients was 47 years (interquartile range [IQR], 36-58), 88% were female, and the median disease duration was 13 years (IQR, 7-20). The median FCCHL score were 3.1 (IQR, 3.0-3.5). The median daily glucocorticoid dose (prednisolone equivalent) was 4 mg (IQR 2-5). HCQ was used in 122 (45.9%) and immunosuppressant was used in 174 (65.4%) of enrolled patients, respectively. FCCHL score were not associated with glucocorticoid dose (r 2 = 0.015). FCCHL score was not statistically different between patients with and without immunosuppressants (median 3.07 [IQR, 2.79-3.36] and 3.04 [IQR, 2.71-3.29], p = 0.81) but statistically different between patients with and without HCQ (median 3.14 [IQR, 2.36-3.93] and 3.00 [IQR, 2.71-3.25], p = 0.0028). After adjustment for confounders, HCQ use was significantly associated with FCCHL score (OR: 2.27, 95% confidence interval: 1.19-4.36). FCCHL score was not statistically associated with SLICC-DI (r 2 = 0.0091). Conclusion Even among the SLE patients who have achieved LLDAS, the preference of HCQ usage may vary depending on health literacy. References [1]Lauren KT et al. Limited health literacy is associated with worse patient-reported outcomes in inflammatory bowel disease. Inflamm Bowel Dis. 2019;25(1):204-212. [2]Federman AD, et al. Asthma outcomes are poor among older adults with low health literacy. J Asthma. 2014;51(2):162-7. [3]Noriaki K et al. Trust in the attending rheumatologist, health-related hope, and medication adherence among Japanese systemic lupus erythematosus patients. Rheumatology (Oxford) 2022 Oct 3;keac565. Acknowledgements: NIL. Disclosure of Interests KEN-EI SADA Speakers bureau: Speaker's fee from Glaxo Smith Kline K.K., Grant/research support from: Research grant from Pfizer Inc., Yoshia Miyawaki: None declared, Kenta Shidahara: None declared, Shoichi Nawachi: None declared, Yu Katayama: None declared, Yosuke ASANO: None declared, Keigo Hayashi: None declared, Eri Katsuyama: None declared, Takayuki Katsuyama: None declared, Mariko Narazaki: None declared, Yoshinori Matsumoto: None declared, Nao Oguro: None declared, Yuichi Ishikawa: None declared, Natsuki Sakurai: None declared, Chiharu Hidekawa: None declared, Ryusuke Yoshimi: None declared, Dai Kishida: None declared, Takanori Ichikawa: None declared, Yasuhiro Shimojima: None declared, Noriaki Kurita: None declared, Nobuyuki Yajima: None declared.