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Health literacy and medication understanding among hospitalized adults
Author(s) -
Marvanova Marketa,
Roumie Christianne L.,
Eden Svetlana K.,
Cawthon Courtney,
Schnipper Jeffrey L.,
Kripalani Sunil
Publication year - 2011
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.925
Subject(s) - medicine , interquartile range , health literacy , odds ratio , confidence interval , medical prescription , polypharmacy , cross sectional study , physical therapy , emergency medicine , health care , pathology , economics , pharmacology , economic growth
Abstract BACKGROUND: Patients' ability to accurately report their preadmission medications is a vital aspect of medication reconciliation, and may affect subsequent medication adherence and safety. Little is known about predictors of preadmission medication understanding. METHODS: We conducted a cross‐sectional evaluation of patients at 2 hospitals using a novel Medication Understanding Questionnaire (MUQ). MUQ scores range from 0 to 3 and test knowledge of the medication purpose, dose, and frequency. We used multivariable ordinal regression to determine predictors of higher MUQ scores. RESULTS: Among the 790 eligible patients, the median age was 61 (interquartile range [IQR] 52, 71), 21% had marginal or inadequate health literacy, and the median number of medications was 8 (IQR 5, 11). Median MUQ score was 2.5 (IQR 2.2, 2.8). Patients with marginal or inadequate health literacy had a lower odds of understanding their medications (odds ratio [OR] = 0.53; 95% confidence interval [CI], 0.34 to 0.84; P = 0.0001; and OR = 0.49; 95% CI, 0.31 to 0.78; P = 0.0001; respectively), compared to patients with adequate health literacy. Higher number of prescription medications was associated with lower MUQ scores (OR = 0.52; 95% CI, 0.36 to 0.75; for those using 6 medications vs 1; P = 0.0019), as was impaired cognitive function (OR = 0.57; 95% CI, 0.38 to 0.86; P = 0.001). CONCLUSIONS: Lower health literacy, lower cognitive function, and higher number of medications each were independently associated with less understanding of the preadmission medication regimen. Clinicians should be aware of these factors when considering the accuracy of patient‐reported medication regimens, and counseling patients about safe and effective medication use. Journal of Hospital Medicine 2011;. © 2011 Society of Hospital Medicine