Health literacy and adherence to medical treatment in chronic and acute illness: A meta-analysis
Open accessAbstract
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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Health literacy positively predicts treatment adherence in other acute and chronic medical conditions and interventions to improve health literacy can increase adherence.
“This is consistent with the literature showing that health literacy positively predicts treatment adherence in other acute and chronic medical conditions and that interventions to improve health literacy can increase adherence. 53”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [53]
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- Authors
- Miller, T. A.
- Affiliations
- University of California, Riverside (US)
- Corresponding author
- Miller, Tricia A.
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 99
- Issue
- 7
- Pages
- 1079-1086
- ISSN
- 0738-3991 (ISSN-L)
- PMC
- PMC4912447
- OpenAlex
- W2264220972
- Cited by
- 662
- References
- 42
- Citations by year
- 2026: 68 · 2025: 88 · 2024: 83 · 2023: 96 · 2022: 83 · 2021: 77 · 2020: 59 · 2019: 48 · 2018: 30 · 2017: 22 · 2016: 8
- FWCI
- 6.87
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIH (5R03AG27552-02)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- health literacy, medication adherence, health literacy interventions, chronic disease, acute illness, cardiovascular disease, low-income patients, vulnerable patients
- MeSH terms
- Acute Disease, Cardiovascular Diseases, Chronic Disease, Humans, Patient Compliance, Patient Education as Topic, Outcome Assessment, Health Care, Health Literacy
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