Health literacy in hand eczema and atopic dermatitis: Revealing the extent of the problem both in the general and theclinical population

Introduction: Health literacy is defined as the degree to which individ-uals have the capacity to obtain, process, and understand health infor-mation and services needed to make appropriate health decisions.Objectives: To investigate the proportion of patients with HE and ADwith limited health literacy in the Dutch general population, and in atertiary referral center.Methods: Among the general population, participants with HE wereidentified by sending a questionnaire to the participants of the LifelinesCohort Study (n = 135.950). Functional health literacy was measured bythree validated screening questions (Set of Brief Screening Questions(SBSQ)), and communicative and critical health literacy were assessedby three single questions from the validated Dutch Functional Commu-nicative and Critical Health Literacy (FCCHL) questionnaire. Among theclinical population (n = 322) health literacy was measured by the New-est Vital Scale (NVS), a performance based instrument assessing readingand numeracy skills, and by the European Health Literacy Survey Ques-tionnaire (HLS-EU-Q16) a perception based instrument including ques-tions related to health care, disease prevention, and health promotion. Results: Of the 8.550 subjects with HE in the general population,24.7% had limited functional health literacy. In addition, 49.5% and39.1% of the subjects with HE never or occasionally talk and collectinformation about their problems or complaints, respectively. Of the322 patients with AD from the clinical population, 32.4% and 20.3%had limited HL according to the HLS-EU-Q16 and NVS, respectively.Limited health literacy was associated with a lower educational level,older age, and impaired quality of life.Conclusion: A substantial proportion of the subjects with HE and ADreported signs of limited health literacy. This emphasises the need formore awareness of limited health literacy among this patient populations.Further research should evaluate the influence of inadequate health liter-acy on health outcomes and focus on strategies to improve organisa-tional health literacy to eventually improve patient-centred care.