Mapping the construct and measurement of medication literacy: A scoping review

Abstract

Aim To systematically review the literature on definitions, tools and factors associated with medication literacy. Methods We searched on Medline, Lilacs, Cochrane, CINAHL, PsycINFO, Embase, Scopus, Web of Science, databases of theses/dissertations and the references of the selected studies. The screening was carried out by two independent researchers. Observational, experimental or methodological studies were eligible for inclusion. The tools were critically analysed and evaluated regarding the dimensions and statements on medication literacy. Results Thirty‐five studies were included. Most were conducted in China and the United States, included adults and were published after 2010. Different terms were identified for literacy in the context of medication use and the most frequently used was “medication literacy”. Its definition varied, but “medication literacy” was generally defined as the individual ability to understand and act on medication‐related information. Twelve tools were identified. Most included only functional and numerical dimensions of literacy. No instrument covered all the essential statements on medication literacy. The tools had essential limitations in their development and measurement characteristics. Factors associated with medication literacy varied among studies, but the most frequent were age, education and inappropriate self‐medication. Conclusion “Medication literacy” is the recommended term for literacy in the context of medication use. Different definitions were identified, and the most comprehensive was the one proposed by Pouliot in 2018. The tools did not cover all the essential literacy skills for medication use and focused only on functional e numeracy domains. Sociodemographic characteristics and inappropriate self‐medication were the most common factors associated with medication literacy.

Medication Literacy in Hospitalized Older Adults: Concept Development

“…The concept development described in this study reveals that medication literacy in hospitalized older adults is multidimensional and that adjustment of these skills is embedded in a dynamic and potentially complex process. Although the presence of different typologies of cognitive and social skills—functional, interactive, and critical medication literacy skills—is congruent with the findings of previous work ( Emmerton et al, 2012 ; Pantuzza et al, 2020 ; Vervloet et al, 2018 ), in our study, we proposed a more detailed and inclusive understanding of medication literacy skills than has previously been presented in discussions on the topic. The range of skills related to medication literacy reported in the literature is extensive, but the exact nature of these skills is still debated ( Gentizon et al, 2021 ; Pantuzza et al, 2020 ).…”

“…Although the presence of different typologies of cognitive and social skills—functional, interactive, and critical medication literacy skills—is congruent with the findings of previous work ( Emmerton et al, 2012 ; Pantuzza et al, 2020 ; Vervloet et al, 2018 ), in our study, we proposed a more detailed and inclusive understanding of medication literacy skills than has previously been presented in discussions on the topic. The range of skills related to medication literacy reported in the literature is extensive, but the exact nature of these skills is still debated ( Gentizon et al, 2021 ; Pantuzza et al, 2020 ). However, this diversity of views can to a large extent be reduced through the adoption of the three main dimensions described herein: functional, interactive, and critical medication literacy.…”

“…Although medication literacy is considered a research priority in medication safety internationally ( Sheikh et al, 2019 ), findings of recent systematic reviews on existing definitions of this concept and instruments used to measure it revealed inconsistencies across studies concerning the essential skills of medication literacy (i.e., attributes) ( Gentizon et al, 2021 ; Pantuzza et al, 2020 ).…”

“…Despite a recent and important definition that adopted an international perspective ( Pouliot et al, 2018 ), additional research is necessary to clarify the core characteristics of medication literacy and to propose a more operational definition. Moreover, the current definitions of medication literacy fail to consider the specificities of older adults and/or multimorbidity, as the co-occurrence of multiple chronic health conditions within one person ( Gentizon et al, 2021 ; Koroukian et al, 2015 ; Pantuzza et al, 2020 ). Individual factors that potentially interfere with older adults' performance in using medication and that have been shown to be associated with worse medication management include poor vision and declining attention, working and prospective memory, and executive functions ( Advinha et al, 2017 ; Elliott et al, 2015 ; Leat et al, 2016 ; Stilley et al, 2010 ).…”

Information or Habit: What Health Policy Makers Should Know about the Drivers of Self-Medication among Romanians

“…This further highlights the importance of community-level interventions combining individual and environmental change strategies [ 61 ] for addressing behavioral health problems. For example, a school curriculum or a training program offered by patients’ organizations on health and medication literacy [ 62 , 63 ] could be coupled with a normative messaging intervention (describing the decisions of people from the same reference group as the target population), leveraging group dynamics in addition to individual behavior change [ 64 ].…”