Document Type : Original Article
Authors
1
Department of public health and community medicine, Faculty of medicine, Al-Azhar university, Damietta, Egypt
2
Department of public Health and Community Medicine, Faculty of Medicine for boys, Al-Azhar University, Cairo, Egypt
3
Department of public health, occupational health and industrial medicine, Faculty of medicine for boys, Al-Azhar University, Cairo, Egypt
Abstract
Background: Health literacy is a key determinant of health outcomes, particularly among elderly patients with chronic diseases. Drug adherence is especially critical for managing multiple chronic conditions in older adults, as inadequate adherence can lead to adverse health outcomes. This study aimed to assess the relationship between health literacy and medication adherence among elderly patients with chronic diseases in Damietta governorate and to identify the key predictors of adherence.
Patients and methods: A cross-sectional study was conducted among 335 elderly patients [aged ≥60 years] with chronic diseases. Data were collected through structured interviews using validated Arabic versions of Comprehensive and Functional Health Literacy Scales [CHL and FHL], and the General Medication Adherence Scale [GMAS]. Descriptive statistics, correlation analysis, and stepwise linear regression were performed using SPSS version 27.
Results: The study revealed a high prevalence of limited medication adherence, with 42.7% of participants demonstrating poor adherence. More than half of participants had inadequate comprehensive [52.8%] and functional [62.4%] health literacy. A strong positive correlation was observed between health literacy and medication adherence [rs = 0.600, p < 0.001]. Regression analysis identified medical insurance [β = 0.276, p < 0.001], CHL [β = 0.180, p < 0.001], and FHL [β = 0.153, p = 0.003] as significant positive predictors of adherence, while lower socioeconomic status [β = -0.244, p < 0.001] and a higher number of chronic diseases [β = -0.199, p < 0.001] were strong negative predictors.
Conclusion: Health literacy significantly influences medication adherence among elderly patients with chronic diseases. Poor adherence was associated with inadequate health literacy, lower socioeconomic status, and a higher burden of chronic diseases. Interventions aimed at improving health literacy and expanding healthcare access through medical insurance may enhance adherence in this population.
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