Hospital Practices and Research

Abstract Background: Treatment adherence is a critical factor in controlling symptoms and determining the success of treatment in chronic disease management.
Objectives: The aim of this study was to investigate the relationship between health literacy levels and adherence to pharmacological treatment in patients with Rheumatoid Arthritis (RA).
Methods: This cross-sectional study included 196 patients. The mean age of participants was 47.35 ± 15.95 years. Socio-demographic and clinical characteristics of the patients were recorded. Health literacy levels were assessed using the Türkiye Health Literacy-32 (THL-32) Scale. Medication adherence to the pharmacological treatment was assessed using the Medication Adherence Report Scale (MARS).
Results: THL-32 and MARS scores were compared according to the demographic characteristics, and a significant difference was found between the education level and place of residence groups. A multivariate regression model was used to assess the connection between them. Health literacy was found to be 3.88 times higher in urban areas compared to rural areas, 4.12 times higher in those with high school education compared to primary school, and 4.39 times higher in those with higher education compared to other levels. In terms of medication adherence, it was found to be 4.18 times higher in urban areas compared to rural areas, 3.1 times higher in those with high school education compared to primary school, and 3.6 times higher in those with higher education compared to other levels.
Conclusion: This study demonstrated that health literacy is positively associated with medication adherence in patients with rheumatoid arthritis. These findings highlight the importance of focusing on health literacy to improve adherence to treatment. Health professionals should prioritize enhancing health literacy to support better disease self-management and treatment outcomes.

Abstract Background: The risk of fractured vertebral increases in patients with rheumatoid arthritis as they are more likely to suffer from osteopenia, and osteoporosis.
Objectives: This study aimed to investigating the rate and risk factors of vertebral fractures in patients with rheumatoid arthritis.
Methods: We recruited 201 patients aged between 30 and 70 who attended the rheumatology department at Shahid Hemn Teaching Hospital in Sulaymaniyah, between January and September 2022. Medical records were reviewed for disease and treatment characteristics while also clinically evaluated by a rheumatologist. Spinal radiographs were assessed by two experienced radiologists blinded to patients’ clinical diagnosis and status. Compression fractures were classified by using the Genant semiquantitative method, and the type of fracture was classified as wedged fracture, biconcave fracture, or crushed fracture.
Results: Of the 201 included participants, 151 were female, and 50 were male. The BMI of women was higher than men by nearly four points (P<0.001). Most women were also illiterate (68/151, 45.0%) and unemployed (139/151, 92.1%). Hypertension (28.4%) and diabetes mellitus (14.4%) were the most reported comorbidities. Women were more likely to have higher DAS28 scores while men had more vertebral fractures (P=0.003). The probability of fractures increased with age, male sex, and illiteracy compared to primary school, osteopenia, and osteoporosis through simple and multiple logistic regression models.
Conclusion: With at least one fracture affects females and males at a rate of 27.8% and 52.0%, respectively. Also reported that age, male sex, illiteracy, osteopenia, and osteoporosis significantly increase the risk of fractures.