Patient Preference and Adherence (Sep 2025)
Assessing Medication Literacy and Its Determinants in Chinese Patients with Multimorbidity
Abstract
Xinyi Li,1,2 Changcheng Shi,2,3 Lihong Liu,1 Yibo Wu4 1Department of Pharmacy, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 2China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China; 3Department of Pharmacy, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, People’s Republic of China; 4School of Public Health, Peking University, Beijing, People’s Republic of ChinaCorrespondence: Lihong Liu, Department of Pharmacy, China-Japan Friendship Hospital, Beijing, People’s Republic of China, Email [email protected] Yibo Wu, School of Public Health, Peking University, Beijing, People’s Republic of China, Email [email protected]: To investigate the medication literacy and influencing factors among patients with multimorbidity.Methods: A cross-sectional survey was conducted to assess medication literacy using the medication literacy scale in patients with multimorbidity. Data were collected between June 20 and August 31, 2023, using stratified and quota sampling methods. The Wilcoxon tests or Kruskal–Wallis tests, Pearson’s correlation analysis, and multiple stepwise linear regression were employed for the analysis.Results: 3,955 patients with multimorbidity were included, with the average medication literacy score of 18.56± 4.52 (scale range: 6– 30). Younger age groups (18– 30, 31– 44, 45– 59 years) had higher medication literacy than those aged 60 years or older (β = 0.11, 0.14, 0.17 respectively; all P < 0.01). Higher education levels (middle/secondary degree, college/university degree, postgraduate degree) correlated with higher medication literacy compared to primary or lower education (β =0.21, 0.28, 0.13 respectively; all P < 0.01). Currently married (β =0.09, P < 0.01), unmarried (β =0.15, P < 0.01), and divorced individuals (β =0.06, P < 0.01) all exhibited higher medication literacy compared to widowed individuals. Compared with people living in Eastern China, those in Central/Western China (β =– 0.06, – 0.07, respectively; all P < 0.01) had lower medication literacy. People whose area was urban (β =0.07, P < 0.01) showed higher medication literacy compared with the rural. A higher score of depressive symptoms (β =– 0.20, P < 0.01) was negatively correlated with medication literacy, and a higher level of social support (β = 0.17, P < 0.01) was positively correlated with medication literacy.Conclusion: It is critically important to improve medication literacy in patients with multimorbidity, particularly by optimizing medication instructions for understanding. Tailored interventions targeting older, less educated, rural, and central/western populations with emphasis on depression management and social support are needed.Study Registration: ChiCTR2300072573.Keywords: multimorbidity, medication literacy, status, influencing factor
