Development and validation of a Chinese medication literacy measure

Abstract

BackgroundDespite the impact of medication literacy (ML) on patients’ safe use of medications, existing instruments are mostly for general health literacy measurement or designed for specific disease populations, with few specifically designed for ML.ObjectiveTo develop and validate the first Chinese medication literacy measure (ChMLM).MethodsThe ChMLM was developed by a multidisciplinary and bilingual expert panel and subsequently pilot‐tested. The final version had 17 questions in four sections: vocabulary, non‐prescription drug, prescription drug and drug advertisement. Face‐to‐face interviews were administered in a convenience sample of adults with diverse sociodemographic characteristics. Internal consistency was assessed by Cronbach's alpha. Content validity was confirmed by the expert panel, and hypothesis testing was performed to assess construct validity.ResultsA total of 634 adults were interviewed. The mean (SD) total ChMLM score was 13.0 (2.8). The internal validity was acceptable (Cronbach's alpha=0.72). Nine of the ten a priori hypotheses were fulfilled. Younger age, higher income and higher education levels were significantly associated with a higher ChMLM score. Furthermore, higher scores on the ChMLM were associated with higher confidence or less difficulty in writing, reading, speaking and listening abilities in a health‐care encounter. No association was found between ChMLM total scores and frequency of doctor's visits.ConclusionThe ChMLM is a valid and reliable ML measure. It may help pharmacists and other health‐care providers to target patients and problem areas that need interventions with the ultimate goal of preventing medication errors and harm.

Relationship Between Medication Literacy and Medication Adherence in Inpatients With Coronary Heart Disease in Changsha, China

“…Medication literacy is the manifestation of health literacy in the context of medication use, and inappropriate medication use was identified to be significantly associated with low medication literacy level (Kripalani et al, 2008;Zheng et al, 2017;Lee et al, 2017). Although medication literacy is assumed to be related to health literacy, medication literacy needs more skills to practice (Sauceda et al, 2012;Pouliot et al, 2017;Yeh et al, 2017). Some studies have shown that health literacy has an insignificant and weakly positive association with self-reported medication adherence (Zhang et al, 2014;Sawkin et al, 2015;Park et al, 2018), but the findings in our study suggested that medication literacy has a significant association with adherence to medication.…”

The status of medication literacy and associated factors of hypertensive patients in China: a cross-sectional study

“…Approximately 50% of CVD patients have poor adherence to their prescribed medications, which has adverse effects on morbidity, mortality, and recurrent cardiac complications, as well as higher costs [16,17]. Many studies have shown that self-medication of antihypertensive drugs is poor in patients with hypertension, including poor adherence to antihypertensive drugs and medication errors [18]. Therefore, patients' long-term regular use of antihypertensive drugs is an important way to stabilize blood pressure, control the disease and prevent serious complications.…”

Conceptualization, Development and Psychometric Evaluations of a New Medication-Related Health Literacy Instrument: The Chinese Medication Literacy Measurement

“…After pilot testing on 35 participants of the convenient samples, the findings of psychometric analyses were combined with the expert content evaluation to finalize the original measure ( Table 1 ) [ 44 ], and to develop an appropriate format of the 17-item Chinese Medication Literacy Measurement (ChMLM-17) layout (e.g., please see Supplementary File S1 for images of an OTC package label and Rx labels on the Rx bag and box). Table 1 describes the original item stems.…”

“…Potential participants living in the nine cities were referred to surveyors by local leaders or persons-in-charge in community centers, owners of street shops, schoolteachers, pharmacists in community pharmacies, or participants themselves. Other than the student interviewers’ friends, relatives, neighbors, and the customers/members of participating pharmacies and organizations were approached as potential participants [ 44 ]. The remaining potential participants were contacted via either postcards or referred by referees to determine their willingness to be interviewed in either their homes or in a safe, undisrupted public or private location.…”

“…Subsequently, we developed the first Chinese Medication Literacy Measurement (ChMLM) to capture more aspects of patients’ health literacy relevant to medication use in future clinical practice. Preliminary validation data, which focused on the responses from the convenience sample of 602 recruited participants, provided support for continuing the planed large-scale, nationally-representative validation study with the full instrument and developing a short-form ChMLM [ 44 ]. This study aimed to describe the comprehensive development process of this instrument, including the conceptual framework, process of item development and reduction, scoring and application, and to share the instrument, its short form, as well as the English version for further use in real world practice or research.…”