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Background: Studies have reported that medication literacy had a positive effect on medication adherence in patients with hypertension. However, little is known about the mechanism underlying this relationship in patients with hypertension. Objective: The purpose of this study was to investigate the mediating effect of self-efficacy between medication literacy and medication adherence. Methods: A total of 790 patients with hypertension were investigated using the Chinese Medication Literacy Scale for Hypertensive Patients (C-MLSHP), the Morisky Medication Adherence Scale-8 (MMAS-8) and the Medication Adherence Self-efficacy Scale-Revision (MASES-R). Hierarchical regression and the bootstrap approach were used to analyze the mediating effect of self-efficacy on the relationship between medication literacy and medication adherence. Results: A total of 60.9% of hypertensive patients were low adherent to their antihypertensive drug regimens. Self‐efficacy had a significant positive correlation with medication literacy ( r = 0.408, p < 0.001) and medication adherence ( r = 0.591, p < 0.001). Self-efficacy accounts for 28.7% of the total mediating effect on the relationship between medication literacy and adherence to antihypertensive regimens for hypertensive patients. Conclusion: More than half of the hypertensive patients in the study were low adherent to antihypertensive regimens. Self-efficacy had a partial significant mediating effect on the relationship between medication literacy and medication adherence. Therefore, it was suggested that hypertensive patients’ medication adherence might be improved and driven by increasing self-efficacy. Targeted interventions to improve patients’ self-efficacy should be developed and implemented. In addition, health care providers should also be aware of the importance of medication literacy assessment and promotion in patients with hypertension.

Background Multimorbidity has a significant impact on public health and primary care. Medication adherence is recognized as the most effective measure for managing and preventing multimorbidity. Studies have shown that medication literacy has a positive effect on medication adherence in patients with multimorbidity. However, limited knowledge exists regarding the underlying mechanisms of this relationship in older adults with multimorbidity. Therefore, the aim of this study was to investigate the mediating role of self-efficacy in the association between medication literacy and medication adherence in this population. Methods This study employed a cross-sectional design and convenience sampling method to survey older patients with multimorbidity in six communities in Zhengzhou, China, from July 12, 2021, to December 15, 2021. Participants were assessed using a demographic questionnaire, the Chinese Version of the Medication Literacy Scale (C-MLS), the Self-Efficacy for Appropriate Medication Use Scale (SEAMS), and the Chinese Version of the Morisky Medication Adherence Scale-8 (C-MMAS-8). Data were analyzed using descriptive statistics, t-tests, one-way analysis of variance, Pearson correlation analysis, and mediation analysis. Results A total of 350 elderly patients met the inclusion criteria, and 328 valid questionnaires were collected. The mean age of the participants was 74.90 ± 7.37 years, with a slightly higher proportion of males (55.8%) than females (44.2%). The mean score for medication adherence was 4.85 ± 1.57, indicating poor medication adherence among the participants. Medication adherence scores varied significantly among participants of different ages, education levels, employment statuses and kinds of medication (p < 0.01). Scores for medication literacy and self-efficacy showed a significant positive correlation with medication adherence scores (all p < 0.001). The standardized coefficient for the total effect and direct effect of medication literacy on medication adherence was 0.268 (95% CI: 0.201, 0.335) and 0.187 (95% CI: 0.123, 0.252), respectively. After introducing self-efficacy into the model, the standardized coefficient for the indirect effect was 0.081 (95% CI: 0.049, 0.120), indicating that self-efficacy partially mediated the relationship between medication literacy and medication adherence, accounting for 30.22% of the total effect. Conclusion This study might suggest that medication literacy indirectly affected medication adherence in older people with multimorbidity through self-efficacy. Health care providers should be aware of the importance of improving medication literacy and implement strategies aimed at increasing self-efficacy to achieve the goal of improving medication adherence in older adults with multimorbidity.

Few studies have investigated the association between medication literacy and medication adherence as well as the influence of medication literacy on medication adherence in hypertensive patients. Thus, the goal of the present study was to determine the association between medication literacy and medication adherence in hypertensive patients. A cross-sectional survey was conducted between August 2016 and December 2016. Self-administered questionnaires were completed, including a self-developed and structured socio-demographic questionnaire; a self-developed, validated, and self-reported Medication Literacy Scale for Hypertensive Patients (C-MLSHP) used for medication literacy measurement; and the Chinese Version of the Morisky Medication Adherence Scale-8 (C-MMAS-8), an eight-item validated, self-report scale for adherence measurement with a total score range of 0-8. A cut-off of 6 was applied to differentiate adherence levels, including patients with an MMAS score <6 (low adherence), MMAS score = 8 (high adherence), and MMAS score ≥6 and <8 (moderate adherence). In this study, hypertensive patients' medication literacy levels and adherence to antihypertensive agents were identified. Pearson correlation analysis was carried out to identify the correlation between medication literacy and adherence. Binary logistic regression analysis was performed with medication adherence as the outcome variable in order to confirm factors associated with medication adherence. A total of 420 hypertensive patients, including 198 women and 222 men with a mean age of 60.6 years (SD = 12.4), were recruited. The mean score of hypertensive patients on the medication literacy scale was 24.03 (SD = 5.13). The mean scores of the four dimensions of knowledge, attitude, skill, and behavior on the medication literacy scale of this study were 6.22 ± 2.22, 5.04 ± 1.16, 4.50 ± 2.21, and 8.27 ± 1.90, respectively. Regarding medication adherence, the mean score of the C-MMAS-8 in this study was 4.82 (SD = 2.11). A total of 63.6% of patients presented with low adherence, 29.5% presented with moderate adherence, and 7.6% presented with high adherence. The Pearson correlation results showed that medication literacy (r = 0.342, P < 0.01) as a whole variable and the three dimensions of knowledge (r = 0.284, P < 0.01), attitude (r = 0.405, P < 0.01), and behavior (r = 0.237, P < 0.01) were significantly associated with medication adherence. Binary logistic regression analysis indicated that annual income [OR 1.199 (95% CI: 1.011-1.421); P = 0.037] and two dimensions of attitude [OR 2.174 (95% CI: 1.748-2.706); P = 0.000] and behavior [OR 1.139 (95% CI: 1.002-1.294); P = 0.046] in medication literacy were found to be independent predictors of medication adherence. Individuals with better attitudes and behavior literacy in medication literacy were more likely to adhere to the use of antihypertensive agents. Those who had higher annual incomes were more likely to adhere to the use of antihypertensive agents. The levels of medication literacy and medication adherence of hypertensive patients are suboptimal and need to be improved in China. The level of medication literacy in patients with hypertension could affect their adherence to antihypertensive drugs. It was suggested that hypertensive patients' medication adherence could be improved and driven by increasing the medication literacy level, especially in the attitude and behavior domains. Pertinent strategies that are specific to several dimensions of medication literacy should be developed and implemented in order to promote full medication literacy among hypertensive patients, thus facilitating optimal adherence and blood pressure control.

This study aimed to examine the relationship between medication literacy and the degree to which patients are considered capable of medication self‐management, the factors influencing the strength of this relationship and the factors influencing a patient’s capability for medication self‐management. Between January and April 2022, a cross‐sectional survey was conducted on hospitalised patients (65+) with polypharmacy. Medication literacy was evaluated using the MEDication Literacy Assessment of Geriatric patients and informal caregivers (MED‐fLAG). The SelfMED assessment determined a patient’s capability for medication self‐management. The relationship between MED‐fLAG and SelfMED was explored with Pearson’s r . Moderation analysis was used to explore the factors influencing the strength of the relationship between both. Linear regression explored the factors influencing SelfMED scores. In total, 169 patients participated in the study. Patients considered themselves more capable of in‐hospital medication self‐management (8/10 rating) compared to nurses’ and physicians’ opinions (6/10 rating). Interactive medication literacy scored higher (mean = 3.0) than functional (mean = 2.9) and critical medication literacy (mean = 2.8). The more medication literacy skills, the more patients were considered able for medication self‐management by healthcare providers ( r  = 0.630, p < 0.001). Moderation analysis could not reveal any factors that significantly affected the strength of the relationship between both. Age, managing medication independently at home, the number of chronic conditions and medication literacy were significant predictors of a patient’s capability for in‐hospital medication self‐management. This study demonstrated a rather strong correlation between the results of the MED‐fLAG and the SelfMED assessment. Hence, SelfMED can be used as a stand‐alone first screening instrument to determine a patient’s capability for in‐hospital medication self‐management, without first assessing medication literacy. MED‐fLAG can provide valuable insights into the medication literacy of patients considered less capable of managing their medication, allowing medication information and interventions to be tailored to the patient.

Background The Medication Literacy Scale for Adults (MELSA) version I was previously developed among adults with high educational levels. However, the validity of the tool for the general populations was not established. Objective The aim of the study was to develop and evaluate the psychometric properties of the MELSA version II among community-dwelling Turkish adults with both low and high education levels. Methods After the item development and content and face validity testing, test-retest reliability, explanatory factor analysis (EFA), confirmatory factor analysis (CFA), internal consistency, item response theory approach (Rasch analysis), and hypothesis testing were carried out. Results The interclass correlation coefficient (agreement) was 0.753 between the test and the two weeks retest. Kuder Richardson-20 was 0.89 with a unidimensional structure, according to EFA, CFA, and Rasch analysis. Rasch analysis indicated the person reliability of the 9-item MELSA version II as 0.74. Participants with a high education level and a high level of self-reported reading ability for health-related information had a higher score on MELSA version II ( p  < 0.05). Conclusion The 9-item MELSA version II is a web-based scale that is brief, valid, and easy to administer in person using an mobile device. It could be used in different countries and populations after conducting appropriate translation and cultural adaptation.

Background Technological anxiety has a multidimensional negative effect on the medical process of elderly patients with chronic co-morbidities, which is mainly reflected in the increase of cognitive load and the decrease of doctor-patient interaction efficiency. The challenge of how elderly patients can more effectively use digital health technologies is a critical issue that both healthcare providers and patients must address. We aimed to explore technology anxiety in elderly patients with chronic co-morbidities by identifying and characterising distinct technology anxiety profiles using latent profile analysis. Methods This study explored the relationship between the Technology Anxiety Scale and the Self-perceived Burden Scale, as well as the different subgroups of medication literacy, using latent profile analysis. The study involved 611 elderly patients with chronic diseases. The research tools used were the Medication Literacy Scale for Elderly Patients with Chronic Diseases, the Self-perceived Burden Scale, and the Technology Anxiety Scale. Results Latent profile analysis revealed four distinct technology anxiety groups of elderly patients with comorbid chronic diseases: low technology anxiety type with 212 cases (34.70%), high technology anxiety type with 81 cases (13.26%), medium technology anxiety low privacy security type with 148 cases (24.22%), and medium technology anxiety high privacy security type with 170 cases (27.82%).The results of multivariate logistic regression analyses indicated that self-Perceived burden, medication literacy, personal monthly income, medical insurance type, daily exercise duration, and times of hospitalizations are significant factors influencing technology anxiety among elderly patients with comorbid chronic diseases. Conclusion The study showed that higher scores in self-perceived burden and medication literacy, lower daily exercise duration, higher hospitalization frequency, lower personal monthly income, and self-funded medical insurance types are associated with more severe technical anxiety.It is recommended that healthcare professionals tailor interventions to address the specific vulnerabilities of each patient type, aiming to reduce technological anxiety and enhance their ability to utilize health information effectively.

BackgroundLow 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.AimTo evaluate the psychometric properties and provide norms for TELUMI scores.MethodThis 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.ResultsA 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).ConclusionThe results suggest that the 29-item version of TELUMI is psychometrically adequate for measuring medication literacy in older adults.

Medication literacy is critical for the safe and effective use of medications. Patients with inflammatory bowel disease (IBD) face complex and evolving medication regimens. However, little is known about medication literacy in this population. This study aimed to explore the experiences and practices of patients with IBD to characterize their current level of medication literacy. A descriptive qualitative research design was adopted. From November 2024 to January 2025, adult patients with IBD were recruited using purposive sampling at a tertiary hospital in China. One-on-one semi-structured interviews were conducted with the patients. All interviews were audio-recorded and transcribed verbatim. The data were analyzed using directed content analysis. Qualitative analysis of 16 patients revealed the following characteristics across the five core competencies of medication literacy: (1) Accessing medication information: patients were able to obtain information through various channels, primarily healthcare professionals and the internet, but they were not always proactive in seeking it. (2) Understanding medication information: patients knew the names and dosages of their medications, but their understanding of the reasons for long-term use, treatment-plan adjustments, and monitoring indicators was relatively superficial. (3) Communicating medication information: patients were able to talk with healthcare professionals, but their involvement in shared decision-making was limited and they rarely communicated with fellow patients. (4) Evaluating medication information: patients assessed the credibility of information according to the authority of the source, yet found it difficult to judge accuracy on the basis of their own knowledge. (5) Calculating medication information: patients demonstrated strong ability in calculating dosing times and amounts, although they occasionally relied on external tools to ensure accuracy. Patients with IBD demonstrate a basic level of medication literacy but face challenges across all five dimensions of medication information processing. Findings of this study highlight key components of medication literacy that require development and may provide a foundation for designing targeted assessments and personalized health education programs.

Objective: The objective of this study was to analyze knowledge mapping and demonstrate the status quo, intellectual base, and hotspots in the field of medication literacy. Methods: Using the data from Web of Science Core database, we constructed a knowledge map to visualize medication literacy using CiteSpace, which revealed the power of the studies, core authors and journals, intellectual base, and hotspots in this field. Results: According to an analysis of 2025 literature reports, the stronger studies were mainly conducted at research institutions of higher education in the United States. Core author groups with a higher influence were not identified. The core journals included Patient Educ Couns and Fam Med. The health literacy studies served as the foundation for the medication literacy studies. The keywords formed 13 clusters including 5 major clusters. Conclusion: The topics in medication literacy study focused on instruments assessing medication literacy, measurement and assessment of medication literacy, medication literacy for the prevention of chronic disease and medication treatment adherence, medication literacy education, and family practice. This study provides an insight into medication literacy and valuable information for medication literacy researchers to identify new perspectives on potential collaborators and cooperative institutions and hotspots.

To investigate medication self-management in patients with stroke and its relationship with general demographics, self-efficacy and medication literacy. This was a cross-sectional study. Patients with stroke who received treatment in Jiangnan University Affiliated Hospital between July 2023 and January 2024 were selected as the study participants. The General Characteristics Questionnaire, the Self-Efficacy for Appropriate Medication Use Scale (SEAMS), the Chinese version of the Drug Literacy Scale and the Self-Administration of Medication tool were used to investigate patients with stroke and to analyse the factors influencing the self-management of their medication. A total of 210 patients were included in this study. The average score of medication self-management was 66.71 (standard deviation = 9.55), and SEAMS and medication literacy scores were positively correlated with the total score of medication self-management behaviour. Furthermore, we found that the Barthel index (BI), SEAMS and medication literacy scores were the main predictors of medication self-management behaviour ( = 0.790, < 0.001). This study found that patients with stroke with a lower BI and higher SEAMS or medication literacy scores also had higher levels of medication self-management. The factors discussed in this study may help develop individualised interventions in medication self-management for patients with stroke.