{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T01:10:57Z","timestamp":1778202657281,"version":"3.51.4"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":108,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the association between health literacy (HL) and disease activity in patients with recent-onset rheumatoid arthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cross-sectional study of patients with rheumatoid arthritis (RA) of \u2264 5\u2009years\u2032 duration. Demographic, clinical and laboratory data were collected during routine follow-up visits. HL was assessed using the SAHLSA questionnaire, a validated measure of functional health literacy. A multivariate model was developed to evaluate the association between HL level and disease activity, measured by DAS28.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 210 patients (81% women) were included with a mean age of 53.9 (14.1) years and a median disease duration of 1.6 [0.4\u20134.28] years. Low health literacy scores (SAHLSA \u226437) were identified in 10.9% (n\u2009=\u200923) of patients. These individuals showed significantly higher disease activity compared with those with higher SAHLSA scores: DAS28-ESR 3.9 (1.6) vs 2.8 (1.4) (P\u2009=\u20090.006), and DAS28-CRP 3.7 (1.4) vs 2.7 (1.2) (P\u2009&amp;lt;\u20090.000). Other measures\u2014physician global assessment (VAS), tender and swollen joint counts, CRP, SDAI, CDAI, and SF-36\u2014were also significantly worse in patients with low HL. In the multivariate analysis, compared with those with higher SAHLSA scores (OR 0.030; 95% CI 0.002\u20130.396; P\u2009=\u20090.008).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low SAHLSA health literacy scores are independently associated with poorer control of inflammatory activity in patients with RA of \u22645 years\u2019 duration. Adapting healthcare communication and support strategies to patients\u2019 health literacy needs early in the disease course may contribute to improved RA management and outcomes<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkag049","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:35:57Z","timestamp":1776339357000},"source":"Crossref","is-referenced-by-count":0,"title":["Health literacy and control of inflammatory activity in patients with recent-onset rheumatoid arthritis"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8954-209X","authenticated-orcid":false,"given":"Javier","family":"Bachiller-Corral","sequence":"first","affiliation":[{"name":"Medicine, Universidad de Alcal\u00e1 , Madrid,","place":["Spain"]},{"name":"Rheumatology Department, Hospital Universitario Ram\u00f3n y Cajal , Madrid,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0519-8821","authenticated-orcid":false,"given":"Mar\u00eda Auxiliadora","family":"Martin-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Hospital Universitario Ram\u00f3n y Cajal , Madrid,","place":["Spain"]},{"name":"INSYCA , Madrid,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8388-7156","authenticated-orcid":false,"given":"Diana","family":"Botello-Corzo","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Complejo Hospitalario Universitario Insular , Las Palmas de Gran Canaria,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1776-9142","authenticated-orcid":false,"given":"Jos\u00e9 L","family":"Morell-Hita","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Hospital Universitario Ram\u00f3n y Cajal , Madrid,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4548-6089","authenticated-orcid":false,"given":"M\u00f3nica","family":"V\u00e1zquez-D\u00edaz","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Hospital Universitario Ram\u00f3n y Cajal , Madrid,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"2026050720532721100_rkag049-B1","first-page":"86p","volume-title":"Health literacy: the solid facts","author":"Kickbusch","year":"2013"},{"key":"2026050720532721100_rkag049-B2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.7326\/0003-4819-155-2-201107190-00005","article-title":"Low health literacy and health outcomes: an updated systematic review","volume":"155","author":"Berkman","year":"2011","journal-title":"Ann Intern 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