TY - JOUR
T1 - Poor knowledge of methotrexate associated with older age and limited English-language proficiency in a diverse rheumatoid arthritis cohort
AU - Barton, Jennifer L.
AU - Schmajuk, Gabriela
AU - Trupin, Laura
AU - Graf, Jonathan
AU - Imboden, John
AU - Yelin, Edward H.
AU - Schillinger, Dean
N1 - Funding Information:
The work of Drs. Barton, Imboden, Graf, and Yelin was supported by funding from the American College of Rheumatology Research and Education Foundation Within Our Reach program and by the Rosalind Russell Medical Research Center for Arthritis, University of California, San Francisco. Ms. Trupin and Dr. Yelin’s work was also supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant P60 AR053308, Multidisciplinary Clinical Research Center). Dr. Schmajuk’s work was supported by the Arthritis Foundation and the UCSF Clinical and Translation Science Institute K12. Dr. Schillinger’s work was supported by NIH/NCRR UCSF-CTSI grant number UL1 RR024131. This article’s contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
PY - 2013/10/22
Y1 - 2013/10/22
N2 - Introduction: Our objective was to determine rheumatoid arthritis (RA) patients' understanding of methotrexate and assess whether knowledge varies by age, education, English language proficiency, or other disease-related factors.Methods: Adults with RA (n = 135) who were enrollees of an observational cohort completed a structured telephone interview in their preferred language between August 2007 and July 2009. All subjects who reported taking methotrexate were asked 11 questions about the medication in addition to demographics, education level, and language proficiency. Primary outcome was a total score below the 50th percentile (considered inadequate methotrexate knowledge). Bivariable and multivariable logistic regressions were performed. Covariates included demographics, language proficiency, education, and disease characteristics.Results: Of 135 subjects, 83% were female, with a mean age of 55 ± 14 years. The majority spoke English (64%), followed by 22% Spanish and 14% Cantonese or Mandarin. Limited English language proficiency (LEP) was reported in 42%. Mean methotrexate knowledge score was 5.4 ± 2.6 (range, 0 to 10); 73 (54%) had a score lower than 5 (of 10). Age older than 55, less than high school education, LEP, better function, and biologic use were independently associated with poor knowledge.Conclusions: In a diverse RA cohort, overall methotrexate knowledge was poor. Older age and limited proficiency in English were significant correlates of poor knowledge. Identification of language barriers and improved clinician-patient communication around methotrexate dosing and side effects may lead to improved safety and enhanced benefits of this commonly used RA medication.
AB - Introduction: Our objective was to determine rheumatoid arthritis (RA) patients' understanding of methotrexate and assess whether knowledge varies by age, education, English language proficiency, or other disease-related factors.Methods: Adults with RA (n = 135) who were enrollees of an observational cohort completed a structured telephone interview in their preferred language between August 2007 and July 2009. All subjects who reported taking methotrexate were asked 11 questions about the medication in addition to demographics, education level, and language proficiency. Primary outcome was a total score below the 50th percentile (considered inadequate methotrexate knowledge). Bivariable and multivariable logistic regressions were performed. Covariates included demographics, language proficiency, education, and disease characteristics.Results: Of 135 subjects, 83% were female, with a mean age of 55 ± 14 years. The majority spoke English (64%), followed by 22% Spanish and 14% Cantonese or Mandarin. Limited English language proficiency (LEP) was reported in 42%. Mean methotrexate knowledge score was 5.4 ± 2.6 (range, 0 to 10); 73 (54%) had a score lower than 5 (of 10). Age older than 55, less than high school education, LEP, better function, and biologic use were independently associated with poor knowledge.Conclusions: In a diverse RA cohort, overall methotrexate knowledge was poor. Older age and limited proficiency in English were significant correlates of poor knowledge. Identification of language barriers and improved clinician-patient communication around methotrexate dosing and side effects may lead to improved safety and enhanced benefits of this commonly used RA medication.
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U2 - 10.1186/ar4340
DO - 10.1186/ar4340
M3 - Article
C2 - 24432366
AN - SCOPUS:84886900767
SN - 1478-6354
VL - 15
JO - Arthritis Research and Therapy
JF - Arthritis Research and Therapy
IS - 5
M1 - R157
ER -