A structural equation model of relationships of health literacy, illness and medication beliefs with medication adherence among patients with chronic obstructive pulmonary disease.
Parul Agarwal, Jenny Lin, Kimberly Muellers and 4 others
PMID 33308880WHAT IT FOUND
In patients with COPD, limited health literacy was associated with lower medication adherence partly through greater concerns about medicines, not directly.
Medication worries may be a useful target for education.
Key findings
01At baseline, participants with limited health literacy were more likely to have low medication adherence than those with adequate health literacy.
02In the adjusted longitudinal model, health literacy had no direct association with medication adherence.
03Lower health literacy was associated with greater medication concerns, and greater concerns were associated with lower medication adherence; this indirect path was significant.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only patients from two urban health systems were studied, so results may not apply to rural or other settings. Medication adherence and beliefs were self-reported and could be influenced by social desirability. Participants who failed vision screening were excluded from health literacy analyses, which may limit generalizability to older adults with visual impairment. The study was not a treatment trial, so it cannot show that changing health literacy or medication concerns would change adherence. Follow-up was not complete for all participants; 85% were followed in year 1 and 75% in year 2. The sample excluded people with asthma, other chronic respiratory illness, dementia, or severe neurological or psychological conditions.
Declared interests
The article reports NIH extramural research support. One author declared a financial relationship with GlaxoSmithKline and membership of EHE International; the remaining authors declared no conflicts.
The easy way to misread this
Do not conclude that improving health literacy alone will improve medication adherence. The study found no direct association between health literacy and adherence, and it was observational with self-reported adherence, so it cannot show cause.