Abstract
BackgroundTo examine whether medication related information processing defined as reading of over-the-counter drug labels, understanding prescription instructions, and information seeking—and medication adherence account for the association between health literacy and quality of life, and whether these associations may be moderated by age and gender.MethodsA sample of 305 adults in South Korea was recruited through a proportional quota sampling to take part in a cross-sectional survey on health literacy, medication-related information processing, medication adherence, and quality of life. Descriptive statistics and structural equation modeling (SEM) were performed.ResultsTwo mediation pathways linking health literacy with quality of life were found. First, health literacy was positively associated with reading drug labels, which was subsequently linked to medication adherence and quality of life. Second, health literacy was positively associated with accurate understanding of prescription instructions, which was associated with quality of life. Age moderation was found, as the mediation by reading drug labels was significant only among young adults whereas the mediation by understanding of medication instruction was only among older adults.ConclusionReading drug labels and understanding prescription instructions explained the pathways by which health literacy affects medication adherence and quality of life. The results suggest that training skills for processing medication information can be effective to enhance the health of those with limited health literacy.
Highlights
To examine whether medication related information processing defined as reading of over-the-counter drug labels, understanding prescription instructions, and information seeking—and medication adherence account for the association between health literacy and quality of life, and whether these associations may be moderated by age and gender
Quality of life was positively associated with perceived medication adherence, understanding prescription instructions, and education but was negatively associated with age, gender, and chronic disease
Health literacy was associated with more reading of the OTC drug labels in both age groups (B = 0.18, p ≤ 0.05 for young adults, B = 0.18, p ≤ 0.05 for old adults), reading the OTC drug labels was linked to perceived medication adherence (B = 0.37, p < 0.01), which was associated with quality of life (B = 0.25, p < 0.01) only in the young adult group
Summary
To examine whether medication related information processing defined as reading of over-the-counter drug labels, understanding prescription instructions, and information seeking—and medication adherence account for the association between health literacy and quality of life, and whether these associations may be moderated by age and gender. Song et al BMC Health Services Research (2017) 17:661 better medication adherence among adults with diabetes, human immunodeficiency virus infection, and heart failure [5,6,7], some studies refuted those findings and reported that low health literacy was associated with better medication adherence [8] or had non-significant associations [9] These inconsistent findings suggest that cognitive and behavioral processes underlying the association between health literacy and medication adherence may involve complex causal pathways, which may not have been articulated in previous studies’ attempts to demonstrate a direct association between them. The previous studies suggested that the processes by which health literacy affects medication adherence and quality of life need to be clarified based on the mixed findings on the associations among health literacy, medication adherence, and quality of life
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