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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; 46:1124-1133. [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] [MESH Headings] [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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Rysdale L, Barohn J. Culinary Medicine and Teaching Kitchens: Dietitians Leading Innovative Nutrition Training for Physicians. CAN J DIET PRACT RES 2024:1-8. [PMID: 39145568 DOI: 10.3148/cjdpr-2024-012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
The objective of this evaluation was to determine the impact of a pop-up Teaching Kitchen (TK) at a national cardiovascular conference. The 60-minute session was hosted in a hotel conference room and led by two registered dietitians. Participants prepared 12 recipes, enjoyed a family-style meal, and explored nutrition behaviour change strategies for patients. Using Likert-scaled and open-ended questions, pre-/post-online surveys assessed change in perceived nutrition counselling skills, attitudes, and confidence; post-survey also assessed effectiveness of session components and further training needs. Pre-survey response was 72% (18/25). Twenty-one participants attended the event (14 pre-registrants, six from waitlist, and five drop-ins); 81% completed the post-survey. Positive shifts were reported in nutrition competence, particularly attitudes towards using recipes in nutrition counselling, and increased skills and confidence discussing eating on a budget and SMART (Specific, Measurable, Achievable, Relevant, and Time-Bound) goal setting with patients. Components of the TK session that enhanced nutrition competence were key patient messages and the shared meal. Preparing and eating together in a hands-on format was most enjoyable. Promoting healthy eating behaviours requires understanding the complexity of individual and societal food literacy. With high physician interest, dietitians are well positioned to deliver culinary medicine interventions and support physicians' confidence in health promotion and chronic disease prevention and management.
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Affiliation(s)
- Lee Rysdale
- Clinical Sciences Division, NOSM University, Sudbury, ON
- Dr. Gilles Arcand Centre for Health Equity, NOSM University, Sudbury, ON
| | - Joel Barohn
- The Culinard Teaching Co., Vancouver, BC
- University of British Columbia, Vancouver, BC
- Nutrition and Health Programs, BC Dairy Association, Burnaby, BC
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Sakai C, Iguchi K, Tachi T, Noguchi Y, Hisamatsu A, Katsuno S, Teramachi H. Effectiveness of distributing pocket cards in improving the behavior, attitude, and knowledge regarding proper medication use among junior high school students in Japan. Front Public Health 2024; 11:1296073. [PMID: 38312136 PMCID: PMC10835787 DOI: 10.3389/fpubh.2023.1296073] [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: 10/03/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
Objective This study aimed to explore the effectiveness of distributing pocket cards with summaries of key information on appropriate medication usage after the implementation of a structured school-based medication education program for junior high school students in Japan. Methods A total of 227 3rd-grade high school students participated in the intervention. Students who received the program without the provision of pocket cards in 2022 were included in the comparison group, and students who took the program with the provision of pocket cards in 2023 were included in the intervention group. After propensity score matching, the final sample of N = 116 comprised n = 58 comparison group participants and n = 58 intervention group participants. Questionnaires were administered at baseline, end-of-class, and 3-month follow-up to assess the changes in behavior, attitude, and knowledge scores. Results The matched intervention group showed significantly lower scores at the 3-month follow-up than the matched comparison group. The results of the multiple linear regression analysis showed that for both groups, only the attitude scores were significantly correlated with the behavior scores. In addition, regardless of the baseline scores, the matched intervention group demonstrated smaller or negative changes in scores at the 3-month follow-up. Conclusion Overall, the results of this study did not support the effectiveness of distributing pocket cards after in-class intervention. However, the usefulness of medication education intervention was confirmed. These results emphasize the need to explore other supplemental teaching tools to further enhance the impact of structured medication education programs.
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Affiliation(s)
- Chihiro Sakai
- Laboratory of Community Pharmacy, Department of Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Kazuhiro Iguchi
- Laboratory of Community Pharmacy, Department of Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Tomoya Tachi
- Laboratory of Hospital Pharmacy, Department of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Yoshihiro Noguchi
- Laboratory of Clinical Pharmacy, Department of Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Aki Hisamatsu
- Education Center of Green Pharmaceutical Sciences, Gifu Pharmaceutical University, Gifu, Japan
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Lopes N, Rodrigues C, Pegado E. Medication literacy and its social contextuality. Health (London) 2023:13634593231211520. [PMID: 38050928 DOI: 10.1177/13634593231211520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
This article aims to contribute to the discussion about medication literacy, by focussing on the social contextuality of the information mobilised in the use of medicines. We aim to explore the social construction processes of medication literacy, as an essential dimension for a more layperson-centred approach in the promotion of literacy in this field. This approach is justified by the growing social and cultural dissemination of medication use, the diversification of its uses beyond health and illness, and the increasing degree of lay autonomy in managing its use. The article is organised in two main sections. In the first section, we review the social history of medication literacy, including a discussion of the social contextuality of literacy phenomena. In the second section, the analysis of social contextuality is operationalised with a focus on information, covering: (i) ways of relating to institutional information and sources of information about medication; (ii) contexts of sociability in which information is shared and validated. This analysis is empirically supported by selected results from two research projects, conducted in Portugal, on the consumption of medicines and dietary supplements for performance purposes - that is, for the management and/or improvement of cognitive, bodily or relational performance.
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Affiliation(s)
- Noémia Lopes
- Iscte - Instituto Universitário de Lisboa, CIES-Iscte, Portugal
- IUEM - Instituto Universitário Egas Moniz, Portugal
| | - Carla Rodrigues
- Iscte - Instituto Universitário de Lisboa, CIES-Iscte, Portugal
- University of Amsterdam, The Netherlands
| | - Elsa Pegado
- Iscte - Instituto Universitário de Lisboa, CIES-Iscte, Portugal
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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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Jiang S, Zhu Z, Liao G, Huang Y, Li L, Zeng K. Relationship Between Medication Literacy and Beliefs Among Persons with Type 2 Diabetes Mellitus in Guangdong, China. Patient Prefer Adherence 2023; 17:2039-2050. [PMID: 37614765 PMCID: PMC10443688 DOI: 10.2147/ppa.s420383] [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: 05/07/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Abstract
Purpose To establish the relationship between medication literacy and medication beliefs among persons with type 2 diabetes mellitus (T2DM). Patients and methods A cross-sectional survey of 246 patients with T2DM was conducted between April and November 2022 at a tertiary hospital in Dongguan City, Guangdong Province, China. Subsequently, these patients were administered the General Information Questionnaire, the Chinese version of Medication Literacy Assessment Scale, and the Chinese version of Beliefs about Medicines Questionnaire-Specific via survey. Results The medication literacy score of patients with T2DM was 7.82±3.007, and the medication beliefs score was 2.26±4.011. The Pearson correlation analysis revealed a statistically significant but weakly positive correlation (r = 0.271, P < 0.001) between medication literacy and beliefs among patients diagnosed with T2DM. However, there was no significant correlation found between medication literacy and necessity (r = -0.021, P > 0.05), while a lowly negative correlation was observed between medication literacy and concerns (r = -0.307, P < 0.001). Moreover, the multiple linear regression analysis indicated that medication literacy, age, education level, and duration of medication usage were all significant factors influencing patients' medication beliefs (all P < 0.05). Together, these variables accounted for 15.3% of the total variance observed in the regression equation. Conclusion The study found a positive correlation between medication literacy and beliefs, and a negative correlation between medication literacy and concerns. These results indicate that enhancing medication literacy can improve medication adherence among individuals with T2DM by reducing concerns and strengthening medication beliefs.
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Affiliation(s)
- Sifen Jiang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
| | - Zhuoqi Zhu
- School of Public Health, Guangxi Medical University, Guangxi, People’s Republic of China
| | - Guisheng Liao
- Emergency Outpatient, Dongguan Eighth People’s Hospital, Dongguan, People’s Republic of China
| | - Yanling Huang
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
| | - Lichang Li
- Endocrinology Department, Dongguan Eighth People’s Hospital, Dongguan, People’s Republic of China
| | - Kun Zeng
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China
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Reijnen E, Laasner Vogt L, Fiechter JP, Kühne SJ, Meister N, Venzin C, Aebersold R. Well-designed medical pictograms accelerate search. APPLIED ERGONOMICS 2022; 103:103799. [PMID: 35588557 DOI: 10.1016/j.apergo.2022.103799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
Two types of newly designed pharmaceutical pictograms (with and without context) were compared with an existing type of certified pictograms regarding their search efficiency. Each of the 30 participants had to search a total of 1'090 "fictitious" medical shelves for a certain box defined by the amount and type of medical instructions given (memory size) and presented among a variable number of other boxes (set size). The boxes contained the different types of pictograms mentioned above. Calculated factorial analyses on reaction time data, among others, showed that the two newly designed pictogram types make search more efficient compared to existing types of pictograms (i.e., flatter reaction time x set size slopes). Furthermore, regardless of the type of pictogram, this set size effect became more pronounced with larger memory sizes. Overall, the newly designed pictograms need fewer attentional resources and therefore might help to increase patient adherence.
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Affiliation(s)
- Ester Reijnen
- ZHAW Zurich University of Applied Sciences, School of Applied Psychology, Pfingstweidstrasse 96, CH-8037, Zürich, Switzerland.
| | - Lea Laasner Vogt
- ZHAW Zurich University of Applied Sciences, School of Applied Psychology, Pfingstweidstrasse 96, CH-8037, Zürich, Switzerland
| | - Jan P Fiechter
- ZHAW Zurich University of Applied Sciences, School of Applied Psychology, Pfingstweidstrasse 96, CH-8037, Zürich, Switzerland
| | - Swen J Kühne
- ZHAW Zurich University of Applied Sciences, School of Applied Psychology, Pfingstweidstrasse 96, CH-8037, Zürich, Switzerland
| | - Nadine Meister
- ZHAW Zurich University of Applied Sciences, School of Applied Psychology, Pfingstweidstrasse 96, CH-8037, Zürich, Switzerland
| | - Claudio Venzin
- ZHAW Zurich University of Applied Sciences, School of Applied Psychology, Pfingstweidstrasse 96, CH-8037, Zürich, Switzerland
| | - Raphael Aebersold
- ZHAW Zurich University of Applied Sciences, School of Applied Psychology, Pfingstweidstrasse 96, CH-8037, Zürich, Switzerland
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Gentizon J, Fleury M, Pilet E, Büla C, Mabire C. Conceptualization and content validation of the MEDication literacy assessment of geriatric patients and informal caregivers (MED-fLAG). J Patient Rep Outcomes 2022; 6:87. [PMID: 35984575 PMCID: PMC9389474 DOI: 10.1186/s41687-022-00495-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/10/2022] [Indexed: 11/25/2022] Open
Abstract
Background The assessment of patients’ medication literacy skills (i.e., abilities to access, comprehend and interact with medication-related information) is an important step in assisting clinicians to plan for appropriate care. Despite several attempts by researchers to develop measures of medication literacy, an instrument tailored to the specific needs of older adults remains a significant shortfall. Therefore, an interprofessional team that included a citizen co-researcher conceptualized a new standardised measure of medication literacy—the MEDedication Literacy Assessment of Geriatric patients and informal caregivers (MED-fLAG). MED-fLAG was designed as a three-dimensional self-reported measure of functional, interactive and critical skills. This study describes the conceptualization process and provides the results of an evaluation of MED-fLAG’s content validity, acceptability, and feasibility during a hospital stay. Methods MED-fLAG was developed in accordance with the guidance on scale development and standards for good content validity, by using the following steps: (I) conceptualization of a provisional version of MED-fLAG; (II) iterative qualitative evaluation of its content validity by older adults, informal caregivers and healthcare professionals. Results The qualitative assessment of the initial 54-item MED-fLAG was conducted in 36 participants, namely 13 home-dwelling older adults and/or informal caregivers and 23 healthcare professionals. Six rounds of revisions were performed to achieve content validity and to propose a 56-item revised MED-fLAG. Participants reported benefits of using a standardized assessment of medication literacy during a hospital stay but warned about certain limitations and prerequisites. The extent to which MED-fLAG could be integrated into discharge planning needs to be further investigated. Conclusions MED-fLAG is the first medication literacy measure tailored to the specific needs of older patients and informal caregivers. A unique feature of this measure is that it includes prescribed and non-prescribed medications, irrespective of the galenic form. Additional studies are required to evaluate the other measurement properties of MED-fLAG, and to reduce the number of items before considering its clinical application. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00495-2. On the basis of what has been written about medication literacy and the experiences of experts, we developed a new questionnaire to measure medication literacy (MED-fLAG) in older adults and/or informal caregivers. MED-fLAG was then submitted to older adults, informal caregivers and healthcare professionals to retrieve their feedback concerning the relevance, comprehensibility and exhaustiveness of the proposed items. In future, MED-fLAG will allow health professionals to evaluate medication literacy skills in older patients during hospitalization and/or in their informal caregivers when they are responsible for preparing or administering the medications, and then propose individualised support.
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Gentizon J, Bovet E, Rapp E, Mabire C. Medication Literacy in Hospitalized Older Adults: Concept Development. Health Lit Res Pract 2022; 6:e70-e83. [PMID: 35389270 PMCID: PMC8973764 DOI: 10.3928/24748307-20220309-02] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jenny Gentizon
- Address correspondence to Jenny Gentizon, MSc, Lausanne University Hospital, Rue du Bugnon 46, Lausanne, Vaud, 1011, Switzerland; jenny.
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Vaillancourt R, Cameron JD. Health literacy for children and families. Br J Clin Pharmacol 2021; 88:4328-4336. [PMID: 34155667 DOI: 10.1111/bcp.14948] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 05/19/2021] [Accepted: 05/30/2021] [Indexed: 11/30/2022] Open
Abstract
The relationship between reading ability and health, known as health literacy, broadly reflects the skills and competencies required to operate within the healthcare environment. It is only recently that we have seen attempts to conceptualize health literacy in the context of medication use by using terms such as medication literacy. Health literacy changes over one's lifetime and is dependent on factors such as numeracy, education, income, gender and country. Low health literacy and low medication literacy have been identified as significant risk factors for poor health outcomes of adults and children. With an evaluation of common tools used to assess health literacy and medication literacy, the aim of this review is to describe the shared responsibility between patients and healthcare providers for the communication of health and medication information. Key strategies and interventions to improve two-way communication between patients and healthcare providers are highlighted, with a focus on how health literacy can impact child health outcomes.
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Neiva Pantuzza LL, Nascimento ED, Crepalde-Ribeiro K, Botelho SF, Parreiras Martins MA, Camila de Souza Groia Veloso R, Gonzaga do Nascimento MM, Vieira LB, Moreira Reis AM. Medication literacy: A conceptual model. Res Social Adm Pharm 2021; 18:2675-2682. [PMID: 34134939 DOI: 10.1016/j.sapharm.2021.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Medication literacy reflects the specific literacy skills necessary to act on medication-related information. A comprehensive and clear conceptual model that reflects medication literacy is lacking. Conceptual models describe the components that represent a construct, allowing for its understanding and providing a rationale for its measurement. OBJECTIVES To propose a conceptual model to support the development of an instrument to measure medication literacy. METHODS This is a three-phase methodological study. A literature review was conducted to identify the components that should be part of the preliminary conceptual model. Subsequently, the importance of its components was judged on a Likert-5 scale. Then, the model was refined, and the dimensions and subdimensions of medication literacy were defined. RESULTS Forty-five experts were included, with a mean age of 39.9 (SD = 10.5) years, most of them females (86.7%) and pharmacists (80%). All components of the preliminary conceptual model were considered important to extremely important by most experts. "Dosing information", "medication name", and "processing the information received about their medication and acting upon medication instructions" were the components considered most important. In the refinement phase, we identified that the construct has four dimensions - functional literacy, communicative literacy, critical literacy, and numeracy, which include the subdimensions to access, understand, evaluate, calculate, and communicate medication-related information. CONCLUSIONS The conceptual model allowed identifying the components that represent medication literacy, which will support the development of an instrument for measuring the construct in Brazil.
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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.
| | - Elizabeth do Nascimento
- Faculdade de Filosofia e Ciências Humanas, Departamento de Psicologia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Kennedy Crepalde-Ribeiro
- 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
| | - 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
| | - Maria Auxiliadora Parreiras Martins
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, 6627 Presidente Antônio Carlos Ave., Pampulha, Belo Horizonte, 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
| | | | - Liliana Batista Vieira
- Faculdade de Ciências Farmacêuticas, Universidade Federal de Alfenas, 700 Gabriel Monteiro da Silva St, Centro, Alfenas, 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
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Information or Habit: What Health Policy Makers Should Know about the Drivers of Self-Medication among Romanians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020689. [PMID: 33466957 PMCID: PMC7830883 DOI: 10.3390/ijerph18020689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/28/2020] [Accepted: 01/09/2021] [Indexed: 02/06/2023]
Abstract
We use the Knowledge, Perceptions and Practices framework to analyze determinants of three types of self-medication practices in Romania: (1) self-medication in the case of cold/flu/viral infections; (2) taking non-prescribed medicine in general; and (3) self-medication based on recommendations by others. We analyzed 706 responses to an online survey and used a factor-based Partial Least Squares algorithm (PLSF) to estimate the relationships between each type of self-medication and possible predictors. Our results show that self–medication is strongly predicted by non-cognitive behavioral factors such as habits and similarity of symptoms, while cognitive determinants such as knowledge and understanding of potential risks are not significantly associated with self-medication behaviors. This paper identifies nonlinear relationships among self-medication practices and its predictors and discusses how our results can help policymakers calibrate interventions with better accuracy.
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Gentizon J, Hirt J, Jaques C, Lang PO, Mabire C. Instruments assessing medication literacy in adult recipients of care: A systematic review of measurement properties. Int J Nurs Stud 2020; 113:103785. [PMID: 33080478 DOI: 10.1016/j.ijnurstu.2020.103785] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/06/2020] [Accepted: 09/27/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The assessment of medication literacy in patients is an important step in assisting clinicians to plan for education, prescription simplification, assistance and/or medication aids. There have been several attempts to develop a standardised, objective measure of medication literacy. The objectives of this systematic review were to critically appraise, compare and summarise the measurement properties of existing instruments that assess medication literacy in adult recipients of care. DESIGN A systematic review was performed. SEARCH METHODS Structured searches were conducted in Embase, MEDLINE PubMed, CINAHL, APA PsycINFO and Web of Science Core Collection in March 2020. Additional searches were performed in ProQuest Dissertations and Theses, DART Europe, and Google Scholar, followed by citation tracking of included studies. REVIEW METHODS Two researchers independently identified eligible studies. Two researchers then assessed the methodological quality of the studies and quality of measurement properties, using the Consensus-based Standards for selection of health Measurement Instruments (COSMIN) guidelines. A best-evidence synthesis for each instrument was performed. RESULTS From the 5035 citations, 17 studies were included that concerned 13 instruments using different administration methods (i.e., performancebased or self-report), medication type (i.e., prescribed or nonprescribed) and context of use (i.e., clinical or community settings). Very low- to moderate-quality evidence supported satisfactory content validity regarding relevance and comprehensibility, while comprehensiveness remained inconsistent. Other measurement properties were less frequently examined and were supported by moderate-quality evidence (i.e., structural validity) to low- or very low-quality evidence (i.e., internal consistency, reliability, construct validity). The bestvalidated instrument is the unidimensional 14-item Medication Literacy in Spanish and English assessment tool (MedLitRxSE), based on direct testing of participant performance regarding four hypothetical scenarios on medication use. Nine instruments have the potential to be recommended but require additional research, while for others, their psychometric soundness is too limited and they require content revisions. CONCLUSION This is the first systematic review to identify instruments for medication literacy. None of the identified instruments had all measurement properties properly assessed and none reported measurement invariance, measurement error and responsiveness of the instrument. Further research is necessary for a better theoretical understanding of medication literacy in order to assist health professionals in identifying patient needs for education, regimen simplification, assistance and/or medication aids. Such research will help conceptualise new instruments that not only cover relevant domains dedicated to specific populations (e.g., polymorbid and/or older individuals), but also exhibit satisfactory measurement properties.
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Affiliation(s)
- Jenny Gentizon
- Institute of Higher Education and Research in Healthcare, Lausanne University Hospital and University of Lausanne, Switzerland; Lausanne University Hospital, Switzerland.
| | - Julian Hirt
- International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Institute for Applied Nursing Sciences, Department of Health, FHS St. Gallen, Switzerland
| | - Cécile Jaques
- Medical Library, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Cedric Mabire
- Institute of Higher Education and Research in Healthcare, Lausanne University Hospital and University of Lausanne, Switzerland
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