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Neiva Pantuzza LL, Reis AMM, Botelho SF, da Rocha ALP, Martins MAP, do Nascimento MMG, Vieira LB, de Souza Groia Veloso RC, do Nascimento E. Medication Literacy Test for Older Adults: psychometric analysis and standardization of the new instrument. Int J Clin Pharm 2024:10.1007/s11096-024-01744-8. [PMID: 38822965 DOI: 10.1007/s11096-024-01744-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/25/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Low medication literacy is prevalent among older adults and is associated with adverse drug events. The Medication Literacy Test for Older Adults (TELUMI) was developed and content validated in a previously published study. AIM To evaluate the psychometric properties and provide norms for TELUMI scores. METHOD This was a cross-sectional methodological study with older adults selected from the community and from two outpatient services. Descriptive item-analysis, exploratory factor analysis (EFA), item response theory (IRT), reliability, and validity analysis with schooling and health literacy were performed to test the psychometric properties of the TELUMI. The classification of the TELUMI scores was performed using percentile norms. RESULTS A total of 344 participants, with a mean age of 68.7 years (standard deviation = 6.7), were included; most were female (66.6%), black/brown (61.8%), had low schooling level (60.2%) and low income (55.2%). The EFA pointed to the one-dimensional structure of TELUMI. A three-parameter logistic model was adopted for IRT. All items had an adequate difficulty index. One item had discrimination < 0.65, and three items had an unacceptable guessing index (< 0.35) and were excluded. The 29-item version of TELUMI had excellent internal consistency (KR20 = 0.89). There was a positive and strong association between TELUMI scores and health literacy and education level. The scores were classified as inadequate medication literacy (≤ 10.0 points), medium medication literacy (11-20 points), and adequate medication literacy (≥ 21 points). CONCLUSION The results suggest that the 29-item version of TELUMI is psychometrically adequate for measuring medication literacy in older adults.
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Affiliation(s)
- Laís Lessa Neiva Pantuzza
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Adriano Max Moreira Reis
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, Minas Gerais, Brazil.
| | - Stephanie Ferreira Botelho
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Luiza Pereira da Rocha
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Auxiliadora Parreiras Martins
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | | | - Liliana Batista Vieira
- Faculdade de Ciências Farmacêuticas, Universidade Federal de Alfenas, 700 Gabriel Monteiro da Silva St., Centro, Alfenas, Minas Gerais, Brazil
| | - Ronara Camila de Souza Groia Veloso
- Hospital das Clínicas, Universidade Federal de Minas Gerais, 110 Professor Alfredo Balena Ave., Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil
| | - Elizabeth do Nascimento
- Departamento de Psicologia, Faculdade de Filosofia e Ciências Humanas, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, Minas Gerais, Brazil
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Antimisiaris D, Folz RJ, Huntington-Moskos L, Polivka BJ. Specific Medication Literacy in Older Adults with Asthma. J Nurse Pract 2024; 20:104979. [PMID: 38706630 PMCID: PMC11064973 DOI: 10.1016/j.nurpra.2024.104979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Purpose To explore specific medication literacy (SML) of older adults and associations of SML strength. Methods This was an observational study. Participants were at least 60 years old, with an asthma diagnosis and in good health. Data were collected by a registered nurse researcher. The SML data collection instrument gathered information about each medication a participant used: name, purpose, how taken, special instructions, adverse effects, and drug-drug or drug-disease interactions. An SML scoring rubric was developed. Results All could provide name, and most provided purpose, how taken. The lowest SML domains were side effects and interactions. Age at time of asthma diagnosis correlated with stronger SML scores and living in a disadvantaged neighborhood correlated with lower SML scores. Discussion Gaps in medication literacy may create less ability to self-monitor. Patients want medication literacy but struggle with appropriate, individualized, information. Conclusion The study provides insights on gaps and opportunities for SML.
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Affiliation(s)
| | - Rodney J. Folz
- Jerald B. Katz Academy, Houston Methodist Research Institute, Houston TX
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Tobiano G, Latimer S, Manias E, Marshall AP, Rattray M, Jenkinson K, Teasdale T, Wren K, Chaboyer W. Co-design of an intervention to improve patient participation in discharge medication communication. Int J Qual Health Care 2024; 36:mzae013. [PMID: 38492231 PMCID: PMC10944286 DOI: 10.1093/intqhc/mzae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/30/2024] [Accepted: 02/20/2024] [Indexed: 03/18/2024] Open
Abstract
Patients can experience medication-related harm and hospital readmission because they do not understand or adhere to post-hospital medication instructions. Increasing patient medication literacy and, in turn, participation in medication conversations could be a solution. The purposes of this study were to co-design and test an intervention to enhance patient participation in hospital discharge medication communication. In terms of methods, co-design, a collaborative approach where stakeholders design solutions to problems, was used to develop a prototype medication communication intervention. First, our consumer and healthcare professional stakeholders generated intervention ideas. Next, inpatients, opinion leaders, and academic researchers collaborated to determine the most pertinent and feasible intervention ideas. Finally, the prototype intervention was shown to six intended end-users (i.e. hospital patients) who underwent usability interviews and completed the Theoretical Framework of Acceptability questionnaire. The final intervention comprised of a suite of three websites: (i) a medication search engine; (ii) resources to help patients manage their medications once home; and (iii) a question builder tool. The intervention has been tested with intended end-users and results of the Theoretical Framework of Acceptability questionnaire have shown that the intervention is acceptable. Identified usability issues have been addressed. In conclusion, this co-designed intervention provides patients with trustworthy resources that can help them to understand medication information and ask medication-related questions, thus promoting medication literacy and patient participation. In turn, this intervention could enhance patients' medication self-efficacy and healthcare utilization. Using a co-design approach ensured authentic consumer and other stakeholder engagement, while allowing opinion leaders and researchers to ensure that a feasible intervention was developed.
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Affiliation(s)
- Georgia Tobiano
- Centre of Research Excellence in Wiser Wound Care, Griffith University, Parklands Drive, Gold Coast, Queensland 4215, Australia
- Gold Coast Health, Gold Coast University Hospital, Hospital Boulevard, Gold Coast, Queensland 4215, Australia
| | - Sharon Latimer
- Centre of Research Excellence in Wiser Wound Care, Griffith University, Parklands Drive, Gold Coast, Queensland 4215, Australia
- School of Nursing and Midwifery, Griffith University, Parklands Drive, Gold Coast, Queensland 4215, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Monash University, Wellington Road, Clayton, Victoria 3800, Australia
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
| | - Andrea P Marshall
- Gold Coast Health, Gold Coast University Hospital, Hospital Boulevard, Gold Coast, Queensland 4215, Australia
- School of Nursing and Midwifery, Griffith University, Parklands Drive, Gold Coast, Queensland 4215, Australia
| | - Megan Rattray
- College of Medicine & Public Health, Flinders University, 1284 South Road, Clovelly Park, Adelaide, South Australia 5042, Australia
| | - Kim Jenkinson
- Gold Coast Health, Gold Coast University Hospital, Hospital Boulevard, Gold Coast, Queensland 4215, Australia
| | - Trudy Teasdale
- Gold Coast Health, Gold Coast University Hospital, Hospital Boulevard, Gold Coast, Queensland 4215, Australia
| | - Kellie Wren
- Gold Coast Health, Gold Coast University Hospital, Hospital Boulevard, Gold Coast, Queensland 4215, Australia
| | - Wendy Chaboyer
- Centre of Research Excellence in Wiser Wound Care, Griffith University, Parklands Drive, Gold Coast, Queensland 4215, Australia
- School of Nursing and Midwifery, Griffith University, Parklands Drive, Gold Coast, Queensland 4215, Australia
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Mei C, Xu B, Cai X, Wan M, Zhao Z, Lv Y, Zhang Y, You R. Factors affecting the medication literacy of older adults and targeted initiatives for improvement: a cross-sectional study in central China. Front Public Health 2024; 11:1249022. [PMID: 38292376 PMCID: PMC10826508 DOI: 10.3389/fpubh.2023.1249022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/29/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction This study explored the state of rational drug use among older adults in central China, aiming to unveil factors influencing their medication literacy and proposing targeted improvement measures. Methods A cross-sectional study involving 454 participants aged 60 and above was conducted in Hubei province between February 1 and May 30, 2023, with data collected through face-to-face interviews by pharmacists. Multiple logistic regression analysis was conducted to determine factors that affected medication literacy. Results Of the 412 valid questionnaires, findings revealed inadequate knowledge of rational drug use among older adults in central China. Those who fully understood (105, 25.49%, OR = 9.349, p < 0.001, 95%CI = 3.884-22.502) or partially understood (228, 55.34%, OR = 3.295, p = 0.002, 95%CI = 1.548-7.013) drug instructions exhibited significantly higher medication literacy than those who did not understand (79, 19.17%). Subsequent research revealed a lack of awareness in reading drug instructions or difficulty in understanding them. Most older adults seldom heard of but exhibited high acceptance of medication guidance services. Discussion In conclusion, the ability to comprehend drug instructions significantly influenced the medication literacy of older adults. Initiatives such as revising age-appropriate drug instructions could effectively enhance rational drug use among this demographic.
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Affiliation(s)
- Chao Mei
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Baoli Xu
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuefeng Cai
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Wan
- Department of Pharmacy, People’s Hospital of Dongxihu District, Wuhan, China
| | - Zhigang Zhao
- Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yongning Lv
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Zhang
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruxu You
- Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Levic M, Bogavac-Stanojevic N, Ubavic S, Krajnovic D. Pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in Serbia. BMC Public Health 2023; 23:1822. [PMID: 37726735 PMCID: PMC10507974 DOI: 10.1186/s12889-023-16639-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Pharmacotherapy literacy (PTHL) is a specific ability to safely access, appraise and understand the available information concerning medication and to calculate and act accordingly. The concept of PTHL is mostly unknown for the majority of diabetes mellitus type 2 (DMT2) patients in Serbia. With diabetes being one of the major public health problems in Serbia with a prevalence of 9.1%, this two-study research aims at constructing performance-based instrument and estimating the prevalence of PTHL levels and identification of predictors of low PTHL scores in patients with DMT2. METHODS Multistage study was performed to adapt the existing performance-based instrument (PTHL-SR) into specific questionnaire for DMT2 population (PTHL-DM instrument). PTHL levels were assessed through cross-sectional study categorising patients into groups of low, medium, and high PTHL levels. We considered 19 predictors for low PTHL scores, from sociodemographic characteristics, health behaviours and health characteristics, access to health-related information and empowerment-related indicators. Univariate and multivariate logistic regression analyses were used to determine independent predictors of low PTHL. RESULTS The final 15-item PTHL-DM instrument proved to have satisfactory reliability (KR20 = 0.475) and internal reliability [ICC for the whole instrument was 0.97 with 95% confidence intervals (0.95-0.99)]. Positive correlation (rho = 0.69) between PTHL-DM score (15 questions) and the total PTHL-SR score (14 questions) was also observed. It was demonstrated that the majority of 350 patients had low PTHL (62%), and only 5% high PTHL level. Mean score on PTHL-DM was 7.8 ± 2.3. Probability of low PTHL increased among smokers, patients with low interest in health and those who estimated their health as bad. Patients who used pharmacists as sourse of information were less likely to be pharmacotherapy illiterate. Combined therapy with insulin and Oral Hypoglycemic Agents was associated with higher PTHL. CONCLUSIONS Our data indicate that specific PTHL-DM tool is objective, valid, and reliable. It was found that low level of PTHL prevailed among DMT2 patients. Medication literacy is influenced by age, residence, education, and family status. Patients with better health literacy also reported better health behaviours. Different patient empowerment programs and approaches aimed at raising PTHL would be essential to improve self-management and control of this widespread chronic disease in Serbia.
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Affiliation(s)
- Marija Levic
- Doctoral Program of Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, Univesrity of Belgrade, 11221 Belgrade, Serbia
| | - Natasa Bogavac-Stanojevic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11221 Belgrade, Serbia
| | - Stana Ubavic
- Medicines and Medical Devices Agency of Serbia (ALIMS), 11221 Belgrade, Serbia
| | - Dusanka Krajnovic
- Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, 11221 Belgrade, Serbia
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Pantuzza LLN, do Nascimento E, Botelho SF, da Rocha ALP, Martins MAP, do Nascimento MMG, Vieira LB, Veloso RCDSG, Reis AMM. Development and content validation of the medication literacy test for older adults (TELUMI). Arch Gerontol Geriatr 2023; 112:105027. [PMID: 37080136 DOI: 10.1016/j.archger.2023.105027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES Medication literacy comprises the skills needed to access, understand, and act on medication information. Low medication literacy is frequent among older adults, making them more susceptible to negative health outcomes. The aim of this study was to develop and evaluate the content validity of an instrument to measure medication literacy in this population. METHOD Multistage methodological study. Items were generated according to a conceptual model and a literature review. The instrument was submitted to a panel of experts to assess item's relevance, clarity, and theoretical classification. Subsequently, the instrument was applied to the target population to assess its comprehensibility. RESULTS Content Validity Index results indicated excellent agreement among experts on the instrument's relevance (0.98) and clarity (0.91). Overall agreement between experts regarding the theoretical subdimensions was moderate [Fleiss' kappa=0.57 (p = 0.00)]. Items were reported to be fully understood by most representatives of the target population. The final version of the instrument had 33 items divided into eight scenarios of medication use. CONCLUSION The instrument seems to have adequate content validity and good suitability for the target population. Therefore, it can help health professionals to identify older adults with low medication literacy, aiming to improve their medication use skills.
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Affiliation(s)
- Laís Lessa Neiva Pantuzza
- Graduate Program in Medicines and Pharmaceutical Services, Faculty of Pharmacy, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, Brazil.
| | - Elizabeth do Nascimento
- Faculty of Philosophy and Human Sciences, Department of Psychology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Stephanie Ferreira Botelho
- Graduate Program in Medicines and Pharmaceutical Services, Faculty of Pharmacy, Federal University of Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, Brazil
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Liu H, Yao Z, Shi S, Zheng F, Li X, Zhong Z. The Mediating Effect of Self-Efficacy on the Relationship Between Medication Literacy and Medication Adherence Among Patients with Type 2 Diabetes. Patient Prefer Adherence 2023; 17:1657-1670. [PMID: 37465055 PMCID: PMC10351528 DOI: 10.2147/ppa.s413385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
Background Patients with type 2 diabetes have poor medication adherence. Medication literacy is one of the influencing factors of medication adherence among patients with type 2 diabetes. However, the mechanism by which medication literacy affects medication adherence among patients with type 2 diabetes is unclear. The aim of this study was to verify the mediating role of self-efficacy in the relationship between medication literacy and medication adherence. Methods A total of 402 patients with type 2 diabetes were enrolled in this study. The Chinese versions of the Medication Literacy Scale, the Self-Efficacy for Appropriate Medication Use Scale and the Morisky Medication Adherence Scale-8 were used in the survey. Pearson correlation analysis was used to find correlations among medication literacy, self-efficacy and medication adherence. The PROCESS macro (Version 4.1) with Model 4 for SPSS was used to verify the mediating role of self-efficacy. Results Twenty-four percent of the participants had poor medication adherence. Self-efficacy and medication literacy (r=0.499, p < 0.01) and medication adherence (r=0.499, p < 0.01) were significantly and positively correlated. Self-efficacy partially mediated the relationship between medication knowledge and medication adherence among patients with type 2 diabetes, accounting for 36.7% of the total effect. Conclusion Self-efficacy had a partial mediating effect on the relationship between medication literacy and medication adherence among patients with type 2 diabetes. Self-efficacy should be improved through effective measures to increase patients' confidence in adherence to antihyperglycemic drugs.
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Affiliation(s)
- Haoqi Liu
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Xiangya Nursing School, Central South University, Changsha, People’s Republic of China
| | - Ziqiang Yao
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Xiangya Nursing School, Central South University, Changsha, People’s Republic of China
| | - Shuangjiao Shi
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Feng Zheng
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Xiangya Nursing School, Central South University, Changsha, People’s Republic of China
- Cardiology Department, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Xia Li
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Endocrinology Department, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Zhuqing Zhong
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Xiangya Nursing School, Central South University, Changsha, People’s Republic of China
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Chang X, Wang K, Wang Y, Tu H, Gong G, Zhang H. Medication Literacy in Chinese Patients with Stroke and Associated Factors: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:620. [PMID: 36612941 PMCID: PMC9819866 DOI: 10.3390/ijerph20010620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
In China, stroke is characterized by high incidence, recurrence, disability, economic burden, and mortality. Regular and effective medication therapy can reduce stroke recurrence. High medication literacy is vital for the success of tertiary prevention measures aimed at preventing recurrence and minimizing disability. A cross-sectional survey using a medication literacy questionnaire was conducted between January and May 2022 on 307 inpatients of a Class III Grade A hospital in Hefei, Anhui Province, China. The demographic and clinical data of the patients were obtained from medical records. The health literacy of the patients was moderate, with 36.8% exhibiting adequate medication literacy. Univariate analysis identified significant differences in the medication literacy of the patients, depending on education level, annual income, family history of stroke, number of health problems, age, daily medication times, and brain surgery history. Multiple regression analysis revealed that education level, annual income, family history of stroke, and number of health problems significantly influenced medication literacy. In patients with stroke who are older and have a low education level, more health problems, no history of surgery, or no family history of stroke or medication guidance, medication knowledge and attitude can be improved to enhance medication safety and guarantee tertiary-level prevention of stroke.
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Affiliation(s)
- Xiao Chang
- The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China
| | - Kai Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China
| | - Yuting Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China
| | - Houmian Tu
- The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China
| | - Guiping Gong
- The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China
| | - Haifeng Zhang
- School of Health Management, Anhui Medical University, Hefei 230032, China
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Gnägi R, Zúñiga F, Brunkert T, Meyer‐Massetti C. Development of a medication literacy assessment instrument (MELIA) for older people receiving home care. J Adv Nurs 2022; 78:4210-4220. [PMID: 36052608 PMCID: PMC9826207 DOI: 10.1111/jan.15429] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/14/2022] [Accepted: 08/20/2022] [Indexed: 01/11/2023]
Abstract
AIM To develop a consensus-based instrument [MELIA] to assess the medication literacy of older home care patients to ultimately optimize medication safety. DESIGN This study was part of the project 'Study of Medication Safety in Home Care' (doMESTIC), which took place from 2016 to 2020 in Switzerland. The development process for the medication literacy assessment instrument encompassed six steps. METHOD First, a scoping literature search was conducted in the Pubmed, CINAHL, EMBASE and Cochrane Library databases as 2) a basis for the development of assessment items. This was followed by 3) a cognitive interview with home care patients and 4) the first round of a Delphi process. Then, 5) a focus group interview with home care experts was conducted before 6) the second Delphi round. The project took place between August 2020 and June 2021. With these different steps, perspectives of both patients and various home care and medication safety experts were included in the development of the assessment instrument. RESULTS A detailed instrument consisting of 20 items as well as a 7-item short version were developed. The short version is intended for efficient preliminary screening to identify patients at high risk for medication management-related problems. CONCLUSION Medication literacy in patients 65 years and older receiving professional home care is a key issue in preventing medication errors. A targeted assessment, starting with an efficient short version of MELIA, allows for prioritization of patients for interventions to optimize medication safety while ensuring their independence as much as possible. IMPACT Systematic assessment of patients' medication literacy helps to provide them with targeted and individual support in their medication management to avoid medication errors and increase patient safety. The development of MELIA is a first step in providing an assessment instrument specifically for the home care setting. PATIENT OR PUBLIC CONTRIBUTION Patient participation was an integral part of the instrument development. The initial 23 items were optimized based on cognitive interviews with four home care patients. The next steps of the instrument development were based on feedback of health care professionals-encompassing advance practice nurses, regular nurses, pharmacists and general practitioners-during a two-step Delphi process as well as a focus group discussion.
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Affiliation(s)
- Rahel Gnägi
- Institute of Nursing Science, Department of Public HealthUniversity of BaselBaselSwitzerland
| | - Franziska Zúñiga
- Institute of Nursing Science, Department of Public HealthUniversity of BaselBaselSwitzerland
| | - Thekla Brunkert
- Institute of Nursing Science, Department of Public HealthUniversity of BaselBaselSwitzerland,University Department of Geriatric Medicine, FELIX PLATTER HospitalBaselSwitzerland
| | - Carla Meyer‐Massetti
- Clinical Pharmacy and Epidemiology, Department of Pharmaceutical SciencesUniversity of BaselBaselSwitzerland,Institute for Primary Health Care BIHAMUniversity of BernBernSwitzerland,Clinical Pharmacology and Toxicology, Department of General Internal MedicineInselspital ‐ University Hospital of BernBernSwitzerland
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Shen Z, Ding S, Shi S, Zhong Z. Association between social support and medication literacy in older adults with hypertension. Front Public Health 2022; 10:987526. [PMID: 36419989 PMCID: PMC9677095 DOI: 10.3389/fpubh.2022.987526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022] Open
Abstract
Background Reduced physical function and reduced social networks place older adults with hypertension at high risk for medication-related harm. Medication literacy is one of the preventable factors that affect the success of drug therapy for hypertension. However, little is known about the level of medication literacy and its influencing factors in older adults with hypertension. Objective The purpose of this study was to investigate the levels of social support and medication literacy, and the association between them in older Chinese adult patients with hypertension. Methods A total of 362 older adult patients with hypertension were investigated using a demographic characteristics questionnaire, the Chinese Medication Literacy Scale for Hypertensive Patients (C-MLSHP) and the Social Support Rating Scale (SSRS). Pearson correlation analysis, canonical correlation analysis (CCA) and hierarchical linear regression were used to analyse the relationship between social support and medication literacy. Results Our results showed that the mean scores for the C-MLSHP and the SSRS for older adult patients with hypertension were 23.89 (SD = 4.66) and 39.22 (SD = 5.53), respectively. The results of the Pearson correlation analysis suggested that the score for social support was positively correlated with the score for medication literacy (r = 0.431, P < 0.01). The results of CCA demonstrate that older adult patients with hypertension who had more subjective (r s = 0.682) and objective support (r s = 0.817) performed better in knowledge (r s = 0.633), skills (r s = 0.631) and behavior literacy (r s = 0.715). Hierarchical linear regression indicated that two dimensions of subjective support (B = 0.252, P < 0.001) and objective support (B = 0.690, P < 0.001) in social support were found to be independent predictors of medication literacy (R2 = 0.335, F = 19.745, P < 0.001). Conclusion Social support is positively associated with medication literacy in older Chinese adult patients with hypertension. The study highlights the importance of social support in promoting medication literacy among older adult patients with hypertension.
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Affiliation(s)
- Zhiying Shen
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China,Clinical Nursing Safety Management Research Center of Central South University, Third Xiangya Hospital, Central South University, Changsha, China,Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
| | - Siqing Ding
- Clinical Nursing Safety Management Research Center of Central South University, Third Xiangya Hospital, Central South University, Changsha, China
| | - Shuangjiao Shi
- Department of Hematology, Third Xiangya Hospital, Central South University, Changsha, China,Clinical Nursing Safety Management Research Center of Central South University, Third Xiangya Hospital, Central South University, Changsha, China,Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China,*Correspondence: Shuangjiao Shi
| | - Zhuqing Zhong
- Clinical Nursing Safety Management Research Center of Central South University, Third Xiangya Hospital, Central South University, Changsha, China,Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China,Zhuqing Zhong
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Zhang Y, Wang X, Cai J, Yang Y, Liu Y, Liao Y, Zhou Y, He B, Wen W, Zhuang Q, Lin Y. Status and influencing factors of medication literacy among Chinese caregivers of discharged children with Kawasaki disease. Front Public Health 2022; 10:960913. [PMID: 36324474 PMCID: PMC9618952 DOI: 10.3389/fpubh.2022.960913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/03/2022] [Indexed: 01/24/2023] Open
Abstract
Background The information on medication literacy among Chinese caregivers of discharged children with Kawasaki disease (KD) is unknown. We aimed to investigate the status of medication literacy among caregivers of discharged children with KD and evaluate the influencing factors of medication literacy. Methods From March 2020 to February 2021, 106 caregivers with a KD child were recruited for the present study. We collected the sociodemographic characteristics of the KD caregivers using structured interviews. The medication literacy of the KD caregivers was assessed by the Chinese version of Medication Literacy Assessment. KD patients' demographic and clinical data were obtained from the medical records. The multiple logistic regression was performed to identify factors associated with medication literacy. Results (1) The average medication literacy score was 4.91 ± 1.51. (2) Most of the Chinese KD caregivers had insufficient medication literacy (≤ 5 scores), and only 39.2% of the caregivers had adequate medication literacy (>5 scores). (3) The multiple logistic regression shows that education level, monthly income, and duration of hospitalization are the independent influencing factors on the medication literacy of KD caregivers. Conclusion There is preliminary evidence that medication literacy among KD caregivers is low and needs improvement. A higher level of education, higher income, and longer duration of hospitalization were influencing factors of adequate medication literacy.
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Affiliation(s)
- Yingzi Zhang
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiuqiong Wang
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jianghui Cai
- Department of Pharmacy, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yanfeng Yang
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China,*Correspondence: Yanfeng Yang
| | - Yiling Liu
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yeling Liao
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yanhong Zhou
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Baoqin He
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wen Wen
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Zhuang
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yonghong Lin
- Department of Obstetrics and Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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