Investigating the association between health literacy and non-adherence

Ostini, Remo; Kairuz, Therése

doi:10.1007/s11096-013-9895-4

Cited by 43 publications

(43 citation statements)

References 47 publications

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“…33 These findings are in accordance with reviews which advocated that health literacy in itself cannot account for medication adherence, but that other variables should also be taken into consideration. 7,8,34 We suggest that self-efficacy is an important mediator of the effect of health literacy on medication adherence. Moreover, besides health literacy and self-efficacy, patients’ acceptance of their doctor’s advice was a covariate in the present model, so it is also an important factor in terms of medication adherence.…”

Section: Discussionmentioning

confidence: 84%

Intentional and Unintentional Medication Non-Adherence in Hypertension: The Role of Health Literacy, Empowerment and Medication Beliefs

Náfrádi

Galimberti

Nakamoto

et al. 2016

Journal of Public Health Research

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BackgroundMedication non-adherence is a major public health issue, creating obstacles to effective treatment of hypertension. Examining the underlying factors of deliberate and non-deliberate non-adherence is crucial to address this problem. Thus, the goal of the present study is to assess the socio-demographic, clinical and psychological determinants of intentional and unintentional non-adherence.Design and methodsA cross-sectional survey was conducted between March, 2015 and April, 2016. The sample consisted of hypertension patients holding at least one medical prescription (N=109). Measurements assessed patients’ medication adherence, health literacy, empowerment, self-efficacy, medication beliefs, and patients’ acceptance of their doctor’s advice, socio-demographic and clinical characteristics.ResultsPatients who occasionally engaged in either intentional or unintentional non-adherence reported to have lower adherence selfefficacy, higher medication concern beliefs, lower meaningfulness scores and were less likely to accept the doctor’s treatment recommendations. Patients who occasionally engaged in unintentional nonadherence were younger and had experienced more side effects compared to completely adherent patients. Adherence self-efficacy was a mediator of the effect of health literacy on patients’ medication adherence and acceptance of the doctor’s advice was a covariate.ConclusionsRegarding the research implications, health literacy and adherence self-efficacy should be assessed simultaneously when investigating the factors of non-adherence. Regarding the practical implications, adherence could be increased if physicians i) doublecheck whether their patients accept the treatment advice given and ii) if they address patients’ concerns about medications. These steps could be especially important for patients characterized with lower self-efficacy, as they are more likely to engage in occasional nonadherence.Significance for public healthMedication non-adherence is a critical public health issue, leading to increased health care costs, morbidity and mortality across several chronic conditions. Medication non-adherence is also one of the main obstacles to effective hypertension care, as between 20-50% of the patients do not follow appropriately their prescribed medication regimen. Despite the large body of empirical evidence available, relatively little is known about the potential differences between the determinants underpinning intentional versus unintentional nonadherence. Shedding light on the factors of medication non-adherence is inevitable to develop interventions and health campaigns addressing the issue. Thus, the present study quantitatively examines the patient-related factors of medication non-adherence to antihypertensive drugs, distinguishing between the determinants of deliberate versus non-deliberate non-adherence. Moreover, based on the outcomes, we advocate potential new approaches to address medication non-adherence in hypertension.

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Section: Discussionmentioning

confidence: 84%

Intentional and Unintentional Medication Non-Adherence in Hypertension: The Role of Health Literacy, Empowerment and Medication Beliefs

Náfrádi

Galimberti

Nakamoto

et al. 2016

Journal of Public Health Research

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“…Medication adherence requires an interaction of several health literacy skills to be able to follow administering instructions and to navigate hospital infrastructure to access treatment and monitoring [41,[43][44][45]. It is now acknowledged that it is the responsibility of all clinicians to communicate healthcare information in a way that patients and carers understand [25].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Non-Adherence to HBV Antiviral Therapy

et al. 2017

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“…For example, many studies of MA in underrepresented groups have targeted low-income subjects or included predominantly low-income subjects without specifically recruiting subjects for these characteristics (Lewis et al, 2012). The potential association between MA and other sociodemographic characteristics such as education level, health literacy, or income may confound understanding of underrepresented samples (Ostini and Kairuz, 2014; Peeters et al, 2011). …”

Section: Discussionmentioning

confidence: 99%

Cultural relevance in medication adherence interventions with underrepresented adults: Systematic review and meta-analysis of outcomes

Conn

Enriquez

Ruppar

et al. 2014

Preventive Medicine

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Objective This meta-analysis systematically compiles intervention research designed to increase medication adherence among underrepresented adults. Method Comprehensive searching located published and unpublished studies with medication adherence behavior outcomes. Studies were included if samples were adults living in North America who had any of the following backgrounds or identities: African American, Native American, Latino, Latino American, Asian, Asian American, Pacific Islander, Native Alaskan, or Native Hawaiian. Random-effects analyses synthesized data to calculate effect sizes as a standardized mean difference and variability measures. Exploratory moderator analyses examined the association between specific efforts to increase the cultural relevance of medication adherence studies and behavior outcomes. Results Data were synthesized across 5,559 subjects in 55 eligible samples. Interventions significantly improved medication adherence behavior of treatment subjects compared to control subjects (standardized mean difference = 0.211). Primary studies infrequently reported strategies to enhance cultural relevance. Exploratory moderator analyses found no evidence that associated cultural relevance strategies with better medication adherence outcomes. Conclusion The modest magnitude of improvements in medication adherence behavior documents the need for further research with clear testing of cultural relevance features.

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Investigating the association between health literacy and non-adherence

Cited by 43 publications

References 47 publications

Intentional and Unintentional Medication Non-Adherence in Hypertension: The Role of Health Literacy, Empowerment and Medication Beliefs

Intentional and Unintentional Medication Non-Adherence in Hypertension: The Role of Health Literacy, Empowerment and Medication Beliefs

Factors Associated with Non-Adherence to HBV Antiviral Therapy

Cultural relevance in medication adherence interventions with underrepresented adults: Systematic review and meta-analysis of outcomes

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