The Effect of Health Literacy Intervention on Patients with Diabetes: A Systematic Review and Meta-Analysis

Abstract

Relevant studies published between January 2010 and June 2021 were identified through relevant databases, including the Science Citation Index Expanded (SCIE) database of Web of Science, PubMed, and Embase, in order to assess the effect of health literacy (HL) intervention on patients with diabetes. A total of 21 articles were eligible. The results showed that: (1) this review involved different HL assessment tools, most of which were self-designed scales and assessment tools focused on measuring functional HL. (2) The differences in glycosylated hemoglobin (HbA1c) (weighted mean difference [WMD] = −0.78, 95% confidence interval [CI]: −0.94, −0.62) and medication adherence (standardized mean difference [SMD] = 1.85, 95% CI: 0.19, 3.52) between the HL intervention group and the usual care group were statistically significant. There was no significant improvement in systolic blood pressure (SMD = −0.05, 95% CI: −0.34, 0.25). Furthermore, this review reported that self-efficacy (SMD = 0.85, 95% CI: 0.65, 1.04) was increased, and the level of HL was improved. In the assessments of risk of bias, 90% of the studies were classified as medium. The quality of the evidence of medication adherence was very low, and the reliability of the conclusions was not enough to confirm the effect of HL.

Impact of health literacy and social support on medication adherence in patients with hypertension: a cross-sectional community-based study

“…A barrier to hypertension self-management is health literacy [ 38 , 39 ], defined as the "capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions". Limited health literacy is known to contribute to poor medication adherence among patients with chronic diseases [ 40 ], including hypertension [ 41 , 42 ], thus resulting in poor management of hypertension and poor blood pressure control. Health literacy has also been positively associated with social support among patients with chronic kidney disease and patients with coronary heart disease.…”

Evaluation of adherence to pharmacological treatments by undocumented migrants with chronic diseases: a 10-year retrospective cohort study

“…This could happen, for example, for health literacy, which is undoubtedly scanty in our patients but has been suggested to have a promoting effect on MA, 13 22 though this has not yet been definitely confirmed. 23 A low level of medical literacy could also entail a reduced awareness of one's disease and of the necessary treatment, and eventually lead these patients not to take the medications they are given for free. Other known factors having a role in MA are higher income, being working and not living alone.…”

Exploring Patient Beliefs and Medication Adherence in the Mediterranean Context: A Cross-Sectional Study in Patients with Cardiovascular Diseases and Cardiometabolic Disorders in Greece—The IACT-Study

“…It is well established in the literature that patients with lower educational attainment may face challenges related to health literacy and understanding the significance of adhering to prescribed medications [ 38 , 39 ]. Limited health literacy has been linked to suboptimal medication adherence in individuals with chronic diseases, leading to inadequate management of their health conditions [ 40 , 41 , 42 ]. Similarly, individuals facing unemployment challenges may experience difficulties accessing healthcare services and medications, leading to reduced adherence.…”