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Background and Purpose: Low levels of health literacy are prevalent worldwide. This report details development and psychometric properties of a health literacy measure for oral medications based on design of the Newest Vital Sign. Methods: The measure was completed during the baseline interview. A principal components analysis evaluated dimensionality of the measure. Cronbach's alpha assessed subscale internal consistencies. Results: Internal consistencies and reliability for the subscales were acceptable for a new instrument (α = .661, α = .686, α = .400). A 3-factor structure explained 65.34% of the total variance. Divergent validity with the Rapid Estimate of Adult Literacy in Medicine (REALM) was established. Conclusions: Our data indicates that the medication health literacy tool is multidimensional, valid, and reliable. This information is important in light of emerging evidence of the impact of health literacy on medication adherence and health.
Keywords: health; literacy; medication; validity; reliability
Health outcomes and costs of health care are clearly related to the degree that patients follow their treatment regimens (Dunbar-Jacob, 2005). There is compelling evidence that patients with chronic illness are not adhering to treatment regimens as prescribed in the United States and around the world (National Council, 2007). Nonadherence has been a persistent problem over the past 25 years despite numerous informational, educational, and behavioral interventions to promote better patient compliance, particularly with medications (Burke & Dunbar-Jacob, 1995). Our aging population, with increasing numbers of comorbid chronic illnesses and comparably complex medication regimens, is at risk of poor physical and emotional health outcomes resulting in marginal quality of life caused by difficulty with adherence to medication regimens (McElnay, McCallion, al-Deagi, & Scott, 1997). An increasing amount of data-based evidence demonstrates that being able to understand basic information about prescriptions impacts significantly on ability to adhere to a medication regimen (Davis et al., 2006; Gazmararian et al., 2006).
BACKGROUND
Health literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (U.S. Department of Health and Human Services, 2012). Medical and phar- maceutical researchers have increasingly focused on health literacy over the past decade, particularly because it relates to adherence with varied treatment regimens (Ngoh, 2009). Low levels of health literacy are prevalent worldwide...