Impact of Health Literacy on Medication Adherence: A Systematic Review and Meta-analysis

    Authors

    N. J. Zhang; A. Terry;C. A. McHorney

    Comments

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    Abbreviated Journal Title

    Ann. Pharmacother.

    Keywords

    adherence; compliance; medication safety; medication therapy management; meta-analysis; ANTIRETROVIRAL ADHERENCE; SELF-MANAGEMENT; OLDER-ADULTS; PREDICTORS; NONADHERENCE; ASSOCIATION; DISPARITIES; GLAUCOMA; THERAPY; EDUCATION; Pharmacology & Pharmacy

    Abstract

    Objective: To systematically review the literature and estimate the effect size of the relationship between health literacy and medication adherence through meta-analysis. Data Sources: Databases searched included Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982-2013), International Pharmaceutical Abstracts (IPA; 1970-2013), MEDLINE OVID (1966-2013), Pub Med (1966-2013), PsycInfo (1966-2013), and Web of Science (1966-2013). Study Selection and Data Extraction: Inclusion criteria were as follows: English language; published through May 1, 2013; medication adherence as the outcome variable; use of validated measures of health literacy and medication adherence; availability of a direct (not mediating) relationship between health literacy and medication adherence; and identifiable effect size and statistical significance of the relationship. Exclusion criteria were as follows: duplicated results, irrelevant results, conference abstracts, proceeding papers, books, dissertations, reviews, editorial letters, continuing education units, or book reviews. Data included author, publication year, disease area, sample size, sampling method, location, study design, effect size of the relationship between health literacy and medication adherence, and measures of health literacy and medication adherence. Data Synthesis: There is a small statistically significant and positive association between health literacy and medication adherence. In the conservative results, the unweighted and weighted correlation coefficients were 0.081 and 0.056 with P values < 0.001. In the less conservative results, the unweighted and weighted correlation coefficients were 0.088 and 0.072. Conclusions: The relationship between health literacy and medication adherence is statistically significant but weak. It is plausible that health literacy has a mediator relationship with other adherence determinants. Future research should explore such relationships.

    Journal Title

    Annals of Pharmacotherapy

    Volume

    48

    Issue/Number

    6

    Publication Date

    1-1-2014

    Document Type

    Review

    Language

    English

    First Page

    741

    Last Page

    751

    WOS Identifier

    WOS:000335291500009

    ISSN

    1060-0280

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