Medication Health Literacy Research Articles

Development and validation of Malaysia Medication Adherence Assessment Tool (MyMAAT) for diabetic patients.

Medication non-adherence remains a significant barrier in achieving better health outcomes for patients with chronic diseases. Previous self-reported medication adherence tools were not developed in the context of the Malaysia population. The most commonly used tool, MMAS-8, is no longer economical because it requires a license and currently every form used is charged. Hence, there is a need to develop and validate a new medication adherence tool. The Malaysia Medication Adherence Assessment Tool (MyMAAT) was developed by a multidisciplinary team with expertise in medication adherence and health literacy. The face and content validities of the MyMAAT was established by a panel of experts. A total of 495 patients with type 2 diabetes were recruited from the Ministry of Health facilities consisting of five hospitals and five primary health clinics. A test-retest was conducted on 42 of the patients one week following their first data collection. Exploratory factor analysis was performed to evaluate the validity of the MyMAAT. The final item for MyMAAT was compared with SEAMS, HbA1c%, Medication Possession ratio (MPR) score, and pharmacist’s subjective assessment for its hypothesis testing validity. The MyMAAT-12 achieved acceptable internal consistency (Cronbach’s alpha = 0.910) and stable reliability as the test-retest score showed good to excellent correlation (Spearman’s rho = 0.96, p = 0.001). The MyMAAT has significant moderate association with SEAMS (Spearman’s rho = 0.44, p = < 0.001) and significant relationship with HbA1c (< 8% and ≥ 8%) (χ2(1) = 13.4, p < 0.001), MPR (χ2(1) = 13.6, p < 0.001) and pharmacist’s subjective assessment categories (χ2(1) = 31, p < 0.001). The sensitivity of MyMAAT-12, tested against HbA1c% was 72.9% while its specificity was 43%. This study demonstrates that the MyMAAT-12 together with other methods of assessment may make a better screening tool to identify patients who were non-adherence to their medications.

Relationship between Health Literacy and Medication Adherence of Turkish Cancer Patients Receiving Oral Chemotherapy

Objective:The aim of this study was to explore the relationship between health literacy and self-report medication adherence of Turkish cancer patients receiving oral chemotherapy.Methods:The present research was a descriptive and cross-sectional study and conducted with 100 voluntary cancer patients who were admitted to the medical oncology outpatient clinic and received oral chemotherapy. The data were collected through a questionnaire form consisting of the Oral Chemotherapy Adherence Scale and the Turkish Health Literacy Scale (TSOY-32). The collected data were analyzed using descriptive statistics, one-way ANOVA, and Pearson's correlation coefficient.Results:The results revealed that 57% of the patients were female, 35% were primary school graduates, 51% were breast cancer, and 36% took capecitabine. The mean index scores of the participants on both scales were calculated as 12.39 ± 1.51 and 73.25 ± 6.18, respectively. Overall, a positive and strong correlation was found between oral chemotherapy adherence and health literacy of the participants (r = 0.707, P = 0.000).Conclusions:Medication adherence and health literacy levels among the cancer patients in Turkey are alarming so that patient-centered interventions and training are required to overcome the barriers to medication adherence.

Effects of Media Health Literacy School-Based Interventions on Adolescents’ Body Image Concerns, Eating Concerns, and Thin-Internalization Attitudes: A Systematic Review and Meta-Analysis

ABSTRACT This systematic and meta-analytic review investigated the effects of media health literacy (MHL) interventions in school settings on adolescents’ body image. Twenty one intervention-control comparisons reported in 16 studies were identified. The following attributes were extracted from each study for a systematic review: Study time-period and country location, sample composition, school atmosphere, unit of random assignment, theoretical perspective, intervention-control comparison, co-interventions, number of overall and MHL sessions, length of MHL sessions, and outcomes measured. The meta-analysis of effect sizes for three outcomes of interest related to body image showed consistent changes in the desired negative direction as expected: body image concerns (g = −0.25, k = 19); eating concerns (g = −0.18, k = 19); thin-internalization attitudes (g = −0.40, k = 12); and combined (g = −0.25, k = 21). Homogeneity analysis for the combined effect size and moderator analyses for gender composition of intervention group, number of overall intervention sessions, number of MHL specific intervention sessions within the overall intervention, and time length of MHL intervention session all showed absence of moderators. However, all study samples except one were of European origin and so caution should be exercised when generalizing to other cultures that may have different standards of female ideal body type.

Abstract 1186: Relationships between health literacy, having a cancer care coordinator, and long-term health-related quality of life among cancer survivors

Abstract Care coordination has been identified as a strategy to reduce challenges navigating the healthcare system for cancer patients. The objective of this study was to assess the association between cancer patients having a cancer care coordinator during their treatment and their long-term health-related quality of life (HRQoL) after treatment, and whether this association differs by level of health literacy. A population-based sample of patients diagnosed with breast, prostate, or colorectal cancer in 2015 were recruited from the Iowa Cancer Registry and invited by mail to participate in an online survey conducted in 2017-2018 (N=369). Survey and Registry data were analyzed using linear regression to model the association between having a cancer care coordinator during active treatment with post-treatment physical or mental HRQoL, a mean of 2.7 years later, by varying levels of health literacy while controlling for sociodemographic and clinical factors.Most patients (81%) reported having one individual coordinating their cancer care. Overall, having a care coordinator was not significantly associated with physical HRQoL (p=0.113). However, patients (20%) with low health literacy, who had a care coordinator, had significantly higher physical HRQoL scores (mean difference 5.0, p=0.022), while those with medium (29%) and high (51%) health literacy, did not (p=0.223, and p=0.864, respectively). Mental HRQoL scores were not associated with the presence of a care coordinator overall or when stratified by health literacy level. Findings suggested care coordinators improved post-treatment physical HRQoL, particularly for patients with low health literacy. Care coordinators may be beneficial to patients struggling to navigate the complex healthcare system during cancer treatment. Future research should focus on the mechanisms by which care coordination affects post-treatment HRQoL. PROMIS Physical HRQoL and CCC by Health Literacy LevelPROMIS Physical HRQoLMultivariable-Adjusted means (95% CI)Cancer Care CoordinatorLow Health LiteracyMedium Health LiteracyHigh Health LiteracyYes49.4 (42.7-56.1)48.9 (43.5-54.3)52.5 (46.1-58.8)No or I Don't Know44.4 (36.2-52.5)46.6 (39.3-53.8)52.1 (45.9-58.4p-valuep=0.0223p=0.2231p=0.8640PROMIS Mental HRQoLMultivariable-Adjusted means (95% CI)Cancer Care CoordinatorLow Health LiteracyMedium Health LiteracyHigh Health LiteracyYes49.7 (44.2-55.1)49.0 (45.5-52.5)55.3 (50.1-60.4)No or I Don't Know47.5 (39.9-55.2)48.1 (43.0-53.3)53.3 (48.3-58.2)p-valuep=0.4099p=0.6168p=0.3360 Citation Format: Natalie J. Del Vecchio, Mary Charlton, Natoshia Askelson, Knute Carter, Elizabeth Chrischilles, Charles Lynch. Relationships between health literacy, having a cancer care coordinator, and long-term health-related quality of life among cancer survivors [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1186.

Known-groups validity and responsiveness to change of the Patient Experience with Treatment and Self-management (PETS vs. 2.0): a patient-reported measure of treatment burden.

The purpose of this study was to test the known-groups validity and responsiveness to change of the Patient Experience with Treatment and Self-management (PETS, vs. 2.0), a measure of treatment burden. The PETS and other standard measures were mailed at baseline and 12-month follow-up to adults living with multiple chronic conditions in southeast Minnesota (USA). A sample of 365 people (mean age = 62.1 years) completed both surveys. Baseline, 12-month, and changes in PETS burden scores were examined. Clinical anchors used to test validity included number of diagnoses (2-4 vs. 5+), mental health diagnosis (yes/no), medication adherence and health literacy (suboptimal/optimal), and changes in self-efficacy, global physical, and global mental health (worsening/improving). Independent-samples t-tests were used to compare scores. PETS scales showed good internal consistency (αs ≥ 0.80). There were few differences across number of diagnoses, but having a mental health diagnosis was associated with higher baseline PETS burden scores (Ps < .05). Suboptimal medication adherence and health literacy over time were associated with worse 12-month PETS burden scores (Ps < .05). Compared with improvements, declines over time in self-efficacy, global physical health, and global mental health were each associated with worsening change scores on PETS impact summary, medical expenses, and bother due to medication reliance and medication side effects (Ps < .05). Among multi-morbid adults, the PETS demonstrated evidence of known-groups validity and responsiveness to change across both objective (e.g., mental health diagnoses) and subjective anchors (e.g., changes in self-efficacy, global physical, and global mental health).

Medication understanding and health literacy among patients with multiple chronic conditions: A study conducted in Bangladesh.

Objectives: Medication understanding is critical for patients who suffer from multiple chronic conditions in order to reduce medication error and is often associated with poor health outcomes and low adherence. This study aims to identify the gap of medication knowledge among multiple chronic condition patients in Bangladesh, in order to aid physicians and other healthcare providers in improving health literacy.Methods: Individual interviews of a convenience sample of multiple chronic condition patients in Bangladesh were held where they were asked a number of questions for assessing medication related literacy.Results: More than 26% patients failed to cite the brand name of all their prescribed medications while the rate of patients not knowing the generic names was far worse (88.1%). Nearly 1 out of every 4 patients did not know the purpose of all their medications and more than half of the participants (55%) did not know the strengths of their drugs. While knowledge about medication routes and regimen was satisfactory, awareness regarding risk factors of medicine was lowest of all. Only 1 out of every 4 patients had a habit of reading drug information leaflet. Patient’s ability to correctly state the purpose of their medication seemed to be positively associated with age (p=0.004) and negatively associated with number of medicines taken (p=0.03).Conclusions: Many patients demonstrated poor health literacy regarding medication. Routine review of medications from physician or health provider can significantly improve their health literacy, leading to better treatment outcome and medication adherence.Significance for public healthDespite having a significant non-communicable disease burden, health literacy and medication understating among patients in Bangladesh is very low. Multimorbidity patients usually consume a high number of medications as part of their treatment, therefore understanding of their medications is critical to ensure no medication error occurs. Identifying the gap of medication knowledge is critical for physicians and other healthcare providers, so that they can be key source for improving health literacy. Our findings suggest sub optimal health literacy regarding medication among the study participants, which can lessen treatment adherence or lead to medication error. Strategies for improving medication understanding is urgently needed for multimorbidity patients, especially physicians and community pharmacists can actively be involved in increasing health literacy of their patients.

Screening for health literacy at an urban academic cancer center.

e19034 Background: Low health literacy is more prevalent among older adults and minority populations, and it has been linked to excess health care utilization and poor health outcomes in cancer patients. Screening for health literacy may improve communication and care, such that discussions and information can be tailored to patient need. The purpose of this study was to describe health literacy levels and correlates among patients at an urban, NCI-designated cancer center. Methods: In September 2019, we began health literacy screening for each newly diagnosed, English-speaking cancer patient. Patients were categorized as having low, medium, or high health literacy using the BRIEF health literacy screener; results are visible in the EMR. For this analysis, we included patient age, gender, insurance type, race/ethnicity, and socio-economic status (SES), which was calculated using an Area Deprivation Index (ADI) ranging from 0 (no deprivation) to 100 (extreme deprivation). Data was summarized using descriptive statistics; ANOVA and Chi-squared tests investigated associations between patient’s health literacy levels and potential correlates. Results: Among 284 patients, 68%, (n = 195) were Caucasian, 25% (n = 70) were African American and 7%, (n = 19) identified as Hispanic, Asian American or some other race. Seventy-five percent (n = 211) were male; the mean age was 63 years (SD: 12). The mean ADI was 42 (SD: 28), indicating a low to moderate SES. Seventy percent (n = 200) had a high health literacy score, 20% (n = 57) had a medium score, and 10% (n = 27) had a low health literacy score. Only a patient’s race/ethnicity and the ADI were significantly associated with their health literacy score. Seventy-seven percent of Caucasian patients had high health literacy scores compared to 59% of African American patients and 48% patients of Hispanic, Asian or some other origin (P &lt; .001). Patients with low health literacy had an ADI score (65.1) that was almost double the score of patients with high health literacy scores (38.5) (p &lt; .001). Conclusions: Roughly one-third of patients seen at this urban cancer center did not have a high health literacy score. Socio-economic status was a stronger correlate to health literacy than patient age, marital status, or insurance type. EMRs should capture a patient’s SES in some manner, as this is strongly associated with health literacy.

Diabetic health literacy and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of a university hospital in Ethiopia.

BackgroundDespite how much effect of low health literacy is on diabetic treatment cannot be accurate, it has an impact on controlling blood glucose level. Less is known about diabetic health literacy in Ethiopian diabetic patients which can affect patient medication adherence, self-care, and glycemic control.ObjectiveThis study was aimed to assess the diabetic health literacy level and its association with glycemic control among adult patients with type 2 diabetes mellitus attending the outpatient clinic of University of Gondar Comprehensive Specialized Hospital (UOGCSH): Northwest Ethiopia.MethodsA cross-sectional study was employed at the outpatient clinic of the University of Gondar Comprehensive Specialized Hospital from May, 1 –May 30, 2019. The comprehensive 15-items diabetic health literacy questions with a 5-point Likert scale used to measure diabetic health literacy. The mean score calculated and switched to the percentage (5 points as 100%) to determine the level of diabetic health literacy. Morisky Green Levine Scale 4 item adherence assessment tool was used to assess the diabetic patient's level of adherence. Binary and multivariable logistic regression analysis was used to assess the association between sociodemographic, clinical variables, diabetic-related literacy, and glycemic control. Independent samples t-test and One-way ANOVA test was employed to compare the mean literacy score difference in different groups.Result400 respondents were included in the study. Of all the respondents, 17.3%, 26.3%, and 56.5% had low, medium and high diabetic-related health literacy, respectively. The proportions of patients with low, medium and high adherence to medication were 9.8%, 56.3%, and 34% respectively. Patients with high diabetes literacy are 1.85 times more likely to achieve target glycemic control than lower diabetic literacy patients with 95% CI Adjusted Odds Ratio (AOR). 1.85(1.09–3.40). While patients with good adherence 1.61 times more likely to achieve target glycemic control than patients with low adherence; 95% CI AOR 1.61(1.04–4.79). Diabetic patients with morbidity have 67% less likelihood to achieve the target glycemic control; 95% CI AOR 0.33(0.15–0.73).ConclusionAdequate diabetic health literacy and better glycemic control are highly correlated. Adjusting all variables; younger age, high diabetic health literacy and good adherence are associated with achieving the target glycemic control.

Relação entre adesão à medicação e letramento funcional em saúde em pessoas idosas

Objetivou-se verificar se há relação entre adesão à medicação e letramento funcional em saúde em pessoas idosas atendidas na Estratégia Saúde da Família da zona oeste de um município no sul do Brasil. Estudo transversal, exploratório-descritivo, quantitativo, realizado em 17 equipes de saúde da família, com 350 pessoas idosas, aplicando-se uma versão em português da Morisky Medication Adherence Scale, que verificou o grau de adesão à medicação e uma versão traduzida do Short-Test of Functional Health Literacy in Adults, que verificou o grau de letramento funcional em saúde. Foi realizada análise estatística descritiva e inferencial. Verificou-se que 224 (64%) participantes foram considerados não aderentes à medicação, e 206 (58,9%) tiveram letramento inadequado, não havendo associação significativa entre essas variáveis. Os participantes relataram outras dificuldades no tratamento medicamentoso, entre elas, o esquecimento teve relação significativa com a adesão. A não compreensão de informações em saúde não influenciou a adesão ao tratamento medicamentoso dos participantes. Os profissionais devem atentar para outras dificuldades que podem surgir, principalmente o esquecimento, elencando estratégias voltadas à minimização do mesmo, como o acompanhamento e monitorização do tratamento medicamentoso.

FACTORS CONTRIBUTING FOR NONCOMPLIANCE OF FOLLOW-UP CARE AMONG POST CARDIAC PATIENTS

Objective: Compliance in following healthy diet, physical activity schedule, cessation of smoking and alcohol, medication adherence and regular follow up is very essential component in the management of patients with cardiovascular disease to prevent reoccurrence and reduce mortality. Hence the study was conducted with the aim to assess the factors contributing for noncompliance of follow-up care among post cardiac patients.&#x0D; Methods: Cross-sectional research design was employed with 50 samples who matched the inclusion criteria were selected by convenience sampling technique. Demographic variables data were collected by using structured questionnaire followed by assessed the factors contributing for noncompliance using checklist.&#x0D; Results: The findings of the current study revealed that all physical, psychological, economical, social and spiritual factors were highly influenced the noncompliance. Of these, the highest percentage 80% reported lack of accessibility as well financial support and around 70% percentage reported side effects of medication and low health literacy.&#x0D; Conclusion: Health care providers need to be focussed on interventional strategies especially health education in discharge plan to ensure that these patients adhere to follow up including medication adherence, following physical activity plan, dietary modification, lifestyle changes and regular follow up visit to prevent readmission and lead a successful life.

Do clinicians convey what they intend? Lay interpretation of verbal risk labels used in decision encounters

ObjectiveTo assess the numerical probabilities that individuals associate with frequently-used verbal labels relating to treatment outcomes and their association with medical context, age, gender, educational level, health literacy, and numeracy. MethodsVerbal labels (N = 11) were extracted from N = 90 audiotaped decision encounters in oncology. Three hundred Dutch adults, as proxies for newly-diagnosed cancer patients, assigned numerical probabilities to the labels in the context of cancer recurrence or nausea, and completed questions on their socio-demographic characteristics, health literacy and numeracy. ResultsWe found considerable variation in how individuals interpreted the verbal labels. Participants’ probability estimates of verbal labels was lower in the context of (the more serious) cancer recurrence compared to (less serious) nausea. Lower numerate participants differentiated less between labels. There was no association between participants’ estimates and age, gender, educational level or health literacy. ConclusionThere is considerable variation in how individuals interpret verbal labels frequently-used in decision encounters. Individuals seem to take base rates and severity of outcomes into account. Verbal labels may be less helpful to lower numerate individuals. Practice implicationsTo minimize misinterpretation and to improve patient-clinician decision making about health and care, we recommend to avoid the use of verbal labels only.

Medication Competence, Numeracy, and Health Literacy.

Two studies investigated the association between medication literacy and numeracy. Study 1 revealed an association between both variables in a sample of adults. Study 2 replicated the finding in a sample of parents of young children, even after controlling for level of parental health literacy. Both studies employed the Medication Literacy in Spanish and English (MedLitRxSE) assessment tool. Objective and subjective numeracy scores were significantly correlated with MedLitRxSE scores in both studies, suggesting that interventions for reducing medication errors might benefit by simplifying the numerical information presented in medication instructions. [HLRP: Health Literacy Research and Practice. 2019;3(3):e181–e186.]

Correlation of health literacy and mobile phone use dependence with psychopathological symptoms in middle school students

Objective: To explore the correlation of health literacy and mobile phone use dependence with psychopathological symptoms in middle school students. Methods: 22 628 middle school students in Shenyang, Bengbu, Xinxiang, Ulanqab, Chongqing and Yangjiang were enrolled by multistage cluster sampling method from November 2015 to January 2016. Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ), Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and Multidimensional Sub-health Questionnaire of Adolescents (MSQA) were applied to acquire basic characteristics, health literacy, mobile phone use dependence and psychopathological symptoms of subjects. Subjects were classified into three groups, low level (<P(25)), medium level (P(25)-P(75)) and high level (>P(75)), according to the percentile of the questionnaire score. Multivariate logistic regression model was used to analyze the correlation of health literacy, mobile phone with psychopathological symptoms. Results: The students were (15.4±1.8) years old with 10 990 boys (48.6%). The score of health literacy of students were (104.1±18.7) points. The rate of mobile phone use dependence was 25.4% (5 752/22 628) and the rate of psychopathological symptoms was 29.1% (6 581/22 628). Compared with high health literacy level, medium and low health literacy levels were related to psychopathological symptoms, with OR (95%CI) about 2.30 (2.10-2.52) and 5.40 (4.89-5.97), respectively. Compared with mobile phone use independence, mobile phone use dependence was related to psychopathological symptoms, with OR (95%CI) about 3.60(3.37-3.85). The highest rate of psychopathological symptoms occurred in students with mobile phone use dependence and low health literacy level [68.0% (1 345/1 977)], with OR (95%CI) about 19.59 (17.07-22.48). Conclusion: Health literacy and mobile phone use dependence are related factors of psychopathological symptoms in middle school students.

Association Between Health Literacy and Medication Adherence Among Hispanics with Hypertension.

Poor adherence to prescribed antihypertensive medication is a major contributor to disparities in effective blood pressure control among Hispanics. The purpose of this study was to investigate the association between health literacy level and adherence to antihypertensive medications among Hispanic adults, who self-reported hypertension, controlling for potential covariates of adherence and/or health literacy. We conducted a cross-sectional survey of 1355 Hispanic adults, primarily Dominicans, who self-reported hypertension. Antihypertensive medication adherence and health literacy were evaluated along with covariates, including sociodemographic characteristics, depression, anxiety, and sleep disturbance. Linear regression models were created for health literacy, each covariate, and adherence. Factors found to be significantly associated with adherence in the individual regression models at a p value of < 0.20 were included in a hierarchical multiple linear regression model. Overall, the majority of participants had low adherence levels to antihypertensive medications (88.4%; n= 1026) and inadequate health literacy (84.9%; n= 1151). When controlling for age, sex, birth country, education level, recruitment location, depression, anxiety, and sleep disturbance, having adequate as compared to inadequate health literacy was associated with a higher adherence score (b= 0.378, p= 0.043). The full model explained 13.6% of the variance in medication adherence (p value < 0.001), but the unique contribution of health literacy to the model was minimal (R2 change = 0.003). Tailored interventions considering health literacy are needed to support medication adherence in order to improve hypertension outcomes of Hispanics. Additional studies are needed to identify and prioritize factors in the development of targeted and effective adherence interventions for Hispanics with hypertension.

Interactive effects between health literacy and mobile phone dependence as well as its relation with unintentional injuries in middle school students

Objective: To investigate the interaction between health literacy, mobile phone dependence and unintentional injuries in middle school students, and to provide guidance for prevention on unintentional injuries in adolescents. Methods: From November 2015 to January 2016, a questionnaire survey was conducted among 22 628 middle school students in Shenyang of Liaoning province, Bengbu of Anhui province, Xinxiang of Henan province, Ulanqab of Inner Mongolia Autonomous Region, Chongqing and Yangjiang of Guangdong province. Chinese Adolescent Interactive Health Literacy Questionnaire (CAIHLQ), Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU), and Unintentional Injuries Assessment Scale and demographic variables were used to measure the health literacy, mobile phone dependence and unintentional injuries among the Chinese middle school students. Results: The detection rates of mobile phone dependence and unintentional injuries were 25.4% and 46.7%, respectively. The rates of unintentional injuries of middle school students with mobile phone dependence and with low, medium and high health literacy were 53.6%, 44.4% and 48.8%, 48.1%, 41.7%. Factors as mobile phone dependence, low and middle health literacy were positively related to unintentional injuries (OR=1.452, 1.196, 1.364). However, the multiplicative interaction between mobile phone dependence and health literacy on unintentional injuries was noticed significant (OR=1.217, 95%CI: 1.041-1.422). Conclusions: Our results showed that the prevalence of unintentional injuries was relatively high in middle school students. Health literacy and mobile phone dependence seemed related to unintentional injuries. Interaction between health literacy and mobile phone dependence on unintentional injuries appeared significant.

Health literacy and medication adherence in cardiac disease

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.

Development of a medication health literacy program for refugees

ObjectivesTo develop a community-based educational workshop to improve medication health literacy in refugees. SettingWorkshops were provided in community locations including a local resettlement agency and English as a Second Language facility. Practice descriptionPharmacy faculty mentored small group student workshop presentations to recently arrived refugees regarding medication health literacy topics. Practice innovationA program was developed to use translated materials, interpreters, hands-on materials, and evaluations to teach refugees about medication-related issues. A needs assessment was conducted with a local refugee resettlement agency to determine topics. EvaluationEvaluations were administered after the workshop to ensure understanding of the workshop material. Verbal feedback and faculty oversight during interactions between pharmacy students and refugees in addition to evaluation responses were used for quality improvement. ResultsWorkshop materials have been translated into 11 of the most common languages for our local refugee population. Twelve workshops were administered during the past year and a half, educating 282 refugees from 33 countries. There was an average of 78% correct responses on postevaluation questions assessing refugees’ understanding of workshop concepts. Verbal feedback from the refugees supported an increase in knowledge regarding how to open a medication bottle, how to read medication labels, and how to dose liquid medications. ConclusionImplementation of this health literacy program allowed us to address medication-related concerns with refugees. Working within the community setting provided a learning environment in which the refugees trusted the workers and were comfortable asking questions. Small group settings and evaluation allowed us to review concepts until proficiency was achieved.

PMU62 - Eq-5d Visual Analog Scale and EQ-5D-5L Taiwan Index Values Among the General Public: Findings From the Participants in National Chinese Medication Health Literacy (CHMLM) Survey in Taiwan

PMU62 - Eq-5d Visual Analog Scale and EQ-5D-5L Taiwan Index Values Among the General Public: Findings From the Participants in National Chinese Medication Health Literacy (CHMLM) Survey in Taiwan

A STUDY OF THE MEDICO-SOCIAL ASPECTS OF MORBIDITY AMONG ADULTS AND CHILDREN IN THE ARAB COUNTRIES OF THE MIDDLE EAST

For morbidity is assessed the health of the population, which influence the socio-economic conditions and lifestyle factors, conditions and external factors Wednesday, biological conditions and factors, conditions and factors of the system and service health care. In Russia regularly examines the details of medico-demographic aspects of population health, but the necessary activities to enhance the health of the population of the countries of the Middle East hampered by various problems. Purpose - a study of the medico-social aspects of morbidity among adults and children in the Arab countries of the Middle East. Materials and methods. The research of health status of the population and the influence of socio-hygienic factors in Yemen, Iraq and Syria during the period of 2005-2010, studied modern informational materials on this issue. Results-the health status of the population of Yemen, Iraq and Syria is under the constant influence of the complex socio-hygienic factors mostly negative for the high morbidity of population, the low availability of medical assistance and health literacy, poor living conditions, material income. The first 5 places in the structure of morbidity of the population occupy: andnfekcionnye and parasitic diseases (28.3%), diseases of bodies of digestion (26.1%), respiratory (13.7%), circulatory (12.3%), injuries ( 3.6%), accounting for 83.5% of pathology. Total morbidity adult and children population of the countries surveyed the first three places are occupied by respiratory diseases, infectious diseases and diseases of the digestive system. Almost half of the urban population have daccess to primary health services in the countries studied, the inhabitants of the village-only every fourth. This process in the period from 2011 to 2017 years worsened in connection with military actions. Correction of the prevailing situation is possible only with the establishment of peace and the use of preventive recommendations.

Media Health Literacy, eHealth Literacy, and the Role of the Social Environment in Context.

Health literacy describes skills and competencies that enable people to gain access to, understand and apply health information to positively influence their own health and the health of those in their social environments. In an increasingly media saturated and digitized world, these skill sets are necessary for accessing and navigating sources of health information and tools, such as television, the Internet, and mobile apps. The concepts of Media Health Literacy (MHL) and eHealth Literacy (eHL) describe the specific competencies such tasks require. This article introduces the two concepts, and then reviews findings on the associations of MHL and eHL with several contextual variables in the social environment such as socio-demographics, social support, and system complexity, as a structural variable. As eHL and MHL are crucial for empowering people to actively engage in their own health, there is a growing body of literature reporting on the potential and the effectiveness of intervention initiatives to positively influence these competencies. From an ethical standpoint, equity is emphasized, stressing the importance of accessible media environments for all—including those at risk of exclusion from (digital) media sources. Alignment of micro and macro contextual spheres will ultimately facilitate both non-digital and digital media to effectively support and promote public health.