Tricia A Miller1. 1. University of California Riverside, Department of Psychology, 900 University Avenue, Riverside, CA 92521, United States. Electronic address: trishmiller122@gmail.com.
Abstract
OBJECTIVE: To use meta-analytic techniques to assess average effect sizes in studies of: (1) the correlation between patient health literacy and both medication and non-medication adherence, and (2) the efficacy of health literacy interventions on improving health literacy and treatment adherence. METHODS: PsychINFO and PubMed databases were searched (1948-2012). A total of 220 published articles met the criteria for inclusion; effect sizes were extracted and articles were coded for moderators. RESULTS: Health literacy was positively associated with adherence (r=0.14), and this association was significantly higher among non-medication regimens and in samples with cardiovascular disease. Health literacy interventions increased both health literacy (r=0.22) and adherence outcomes (r=0.16). Moderator analyses revealed greater intervention efficacy when health literacy and adherence were assessed using subjective measures compared to objective measures. Health literacy interventions had a greater effect on adherence in samples of lower income and of racial-ethnic minority patients than in non-minority and higher income samples. CONCLUSION: This is the first study to synthesize both correlational and intervention studies examining the relationship between health literacy and adherence to both medication and non-medication regimens. IMPLICATIONS: These findings demonstrate the importance of health literacy and the efficacy of health literacy interventions especially among more vulnerable patient groups.
OBJECTIVE: To use meta-analytic techniques to assess average effect sizes in studies of: (1) the correlation between patient health literacy and both medication and non-medication adherence, and (2) the efficacy of health literacy interventions on improving health literacy and treatment adherence. METHODS: PsychINFO and PubMed databases were searched (1948-2012). A total of 220 published articles met the criteria for inclusion; effect sizes were extracted and articles were coded for moderators. RESULTS: Health literacy was positively associated with adherence (r=0.14), and this association was significantly higher among non-medication regimens and in samples with cardiovascular disease. Health literacy interventions increased both health literacy (r=0.22) and adherence outcomes (r=0.16). Moderator analyses revealed greater intervention efficacy when health literacy and adherence were assessed using subjective measures compared to objective measures. Health literacy interventions had a greater effect on adherence in samples of lower income and of racial-ethnic minority patients than in non-minority and higher income samples. CONCLUSION: This is the first study to synthesize both correlational and intervention studies examining the relationship between health literacy and adherence to both medication and non-medication regimens. IMPLICATIONS: These findings demonstrate the importance of health literacy and the efficacy of health literacy interventions especially among more vulnerable patient groups.
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