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

Hsiang-Wen Lin,Yu-Chieh Chen,Yu Ko,Okti Ratna Mafruhah,Yen-Ming Huang,Yu-Shan Wang,Chun-Yu Wang,Elizabeth H Chang,Shang-Hua Wu

doi:10.3390/ijerph17196951

Abstract

There is a need for valid and reliable instruments to focus on medication aspects of health literacy and help healthcare professionals address patients’ barriers to medication use. This cross-sectional study describes the conceptualization, development, and psychometric properties of the first Chinese Medication Literacy Measurement (ChMLM) to assess the level of health literacy on medication use. The 17-item ChMLM (ChMLM-17) and its short form, 13-item ChMLM (ChMLM-13), consist of four sections (vocabulary, over-the-counter labels, prescription labels, and advertisements) to cover six domains of medication-related health literacy. Multistage stratified quota sampling was attempted to recruit a representative sample in Taiwan. Receiver operating characteristic curves were used to identify the cut-off point for differentiating high and low medication literacy. Psychometric analyses were performed (n = 1410) to assess the reliability and validity separately on all samples and sociodemographic subgroups. The 17- and 13-item versions both had high construct validity among all patients and patients with low medication literacy. The developed ChMLM-17 and ChMLM-13 is expected to help healthcare providers and researchers to accurately measure medication-related health literacy and improve medication use in the real-world practice.

Highlights

Medication use, including the consumption of prescription and over-the-counter (OTC)medications, is a common routine for disease management of patients across ages and countries [1].For example, around 70% of adults in North America take at least one prescription medication daily [2], and 40–95% of adults used OTCs in the Arab world, Germany, and Africa [3,4,5,6]
Based on the study of Sauceda et al on the conceptualization of medication literacy [39], we adopted their definition of medication literacy as “the ability of individuals to safely and appropriately acquire, understand, and act upon basic medication information [39]” during the development of this instrument in 2015, as the report by Pouliot et al was not published at that time [23]
This study described the comprehensive development process of the first Chinese medication literacy instrument designed to assess patients’ or general public’s levels of medicationrelated health literacy on medication labels or information of OTC, dietary supplement, and prescription

Summary

Introduction

Medication use, including the consumption of prescription and over-the-counter (OTC)medications, is a common routine for disease management of patients across ages and countries [1].For example, around 70% of adults in North America take at least one prescription medication daily [2], and 40–95% of adults used OTCs in the Arab world, Germany, and Africa [3,4,5,6]. Medication use, including the consumption of prescription and over-the-counter (OTC). Inappropriate use of OTC medications, even if these products are claimed to be safe for self-medication, might cause serious consequences to patients’ health [7,8]. Studies have shown that patients are often confused about medication information provided by pharmaceutical companies and healthcare professionals [8], and that misinterpretation of medication information (e.g., warning label, package label and insert, and medication instruction pamphlet) is linked to medication nonadherence and misuse [9,10]. Misunderstanding of the dosing instruction on medication packages has been cited as a critical factor that contributes to unintentional medication errors and adverse events [11]

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Conclusion