Health literacy and medication adherence in cardiac disease

Abstract

Background: Early mortality arising from cardiac disease can be reduced through the use of medications but medication adherence is often poor. This is influenced by many factors, including health literacy. Systematic reviews indicate the relationship between medication adherence and health literacy is complex and ambiguous although no reviews specifically examine medication adherence in patients with cardiac disease. Aim: The aim was to explore current literature that investigates medication adherence and health literacy in patients with cardiac disease. Method: An integrative review was performed. Results: Patients with cardiac disease had moderate health literacy levels and medication adherence. Four out of eight studies reported lower adherence in people with low health literacy. Additional factors (education, age, intervention strategies, complexity of regimen, cognition, ethnicity, contextual differences, medical insurance and patient beliefs) were found to have stronger associations with adherence. Conclusion: Patients with cardiac disease in the majority of the studies had high levels of medication adherence, which may be influenced by important factors other than health literacy. Further research is needed to investigate these factors while accounting for the potential influence of health literacy.