Yoon K. Loke|I. Hinz|Xia Wang|Gill Rowlands|David G. I. Scott|Charlotte Salter
Impact of Health Literacy in Patients with Chronic Musculoskeletal Disease–Systematic Review
University of East Anglia|University of East Anglia|University of East Anglia|London South Bank University|University of East Anglia|University of East Anglia
estimate prevalence low health literacy evaluate impact low health literacy outcomes patients chronic musculoskeletal conditionswe searched embase pubmed psycinfo cinahl january 2011 relevant studies restricted englishlanguage articlesstudies included measured health literacy andor reported link outcomes health literacy levels patients osteoporosis osteoarthritis rheumatoid arthritis assessed risk bias participant selection methods measuring health literacy functional outcomes missing data potential confoundingwe reviewed 1863 citations judged 8 studies relevant crosssectional nature five based united states diversity measurements participant characteristics settings meant results synthesized narratively prevalence low health literacy varied 7 42 five studies reported musculoskeletal outcomes one showed association unadjusted low health literacy greater pain limitations physical functioning however studies including multivariate analyses found significant relationship health literacy measures pain disease specific questionnaires one clinical trial found shortterm improvements mental health patients musculoskeletal conditions intervention improve health literacymost studies crosssectional nature precludes interpretation causal relationship sample sizes may sufficiently large enable detection significant associationsthe current evidence show consistent association low health literacy poorer functional outcomes patients chronic musculoskeletal conditions absence definite link efforts develop interventions improve health literacy would necessarily improve health service patientrelated outcomes