Background/Purpose: In the case of a complex disease like vasculitis, the patient is often tasked with understanding complicated care plans and managing myriad medications. Without appropriate support for these tasks, however, poor health outcomes may result. Recently, shared decision-making (SDM) has become a strategy for effective disease management, with the focus on the physician’s ability to communicate. However, little attention has been paid to the manner in which the abilities and background of the patient interact with the communication and decision-making process. For this project, the following measures were obtained: patient activation (PAM), a measure of patient engagement, objective numeracy (ONS), a measure of objective math skills, subjective numeracy (SNS), a measure of self-reported math skills, health literacy (sTOFHLA), the Brigham Vasculitis Activity Score (BVAS), and the Vasculitis Damage Index (VDI), measures of activity and damage respectively.

Methods: Participants (N=43) were recruited from the Ohio State University Lupus, Vasculitis, and Glomerulonephritis (LVG). Subjects completed each of the measures indicated above. Pearson’s correlation coefficient (PCC), r, was calculated for each of the variable pairs shown in Table 1. Some subjects were missing data. All available data for each variable were used.

Results: 37 out of the 43 patients had ANCA associated-vasculitis and 3 patients had Takayasu’s vasculitis, one patient each had eosinophilic polyangiitis, CNS vasculitis and Behcet’s syndrome. The ONS scores were relatively low (mean = 3.85 out of a possible 8 maximum score) while the mean PAM score was high (mean = 3.23 out of a possible 4 maximum score). All but one subject had above normal health literacy scores (sTOFHLA > 23). Table 1 illustrates correlations between variables.

Conclusion: Currently, very little evidence exists about the relations between patient activation, numeracy, and disease outcomes in vasculitis patients. Interestingly, although many patients had high patient activation and adequate health literacy scores, they had low math and numerical skills. Subjective and objective numerical ability were correlated, indicating patients who believed they were skilled numerically actually were. Higher activation scores were strongly negatively correlated with both disease damage and activity, indicating that greater engagement in care corresponded to lower disease damage and activity. Surprisingly, higher ONS scores trended with higher disease damage, a relationship that, if it proves robust, merits future investigation.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/understanding-vasculitis-patients-ability-to-work-with-numbers/