Patient Preference and Adherence (Sep 2024)
Health Literacy and Medication Adherence Among Patients with Type 2 Diabetes in Jordan: A Cross-Sectional Study
Abstract
Walid Al-Qerem,1 Anan Jarab,2– 4 Judith Eberhardt,5 Fawaz Alasmari,6 Alaa Hammad,1 Safa M Alkaee,1 Zein H Alsabaa7 1Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan; 2College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates; 3AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates; 4Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; 5Department of Psychology, School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK; 6Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudia Arabia; 7Department of Pharmacy, Faculty of Pharmacy, Petra University, Amman, JordanCorrespondence: Walid Al-Qerem, Email [email protected]: Improving health literacy has been found to play a significant role in enhancing medication adherence in patients with type 2 diabetes.Purpose: The present study aims to evaluate health literacy and its association with medication adherence among diabetic patients in Jordan.Patients and Methods: This cross-sectional study included 400 diabetic patients, predominantly female (68.8%), with a median age of 58 years, attending the endocrinology outpatient clinic at Albasheer Hospital in Amman, Jordan, between August and December 2023. Patients were recruited using convenience sampling, including those aged 18 and older, literate, diagnosed with T2DM for at least one year, and on at least one medication for T2DM. Sample size was calculated based on the Events Per Variable (EPV) criterion to ensure sufficient power for logistic regression analysis. Data were collected using two validated instruments: the Jordanian Diabetic Health Literacy Questionnaire (JDHLQ), assessing health literacy, and the Medication Adherence Report Scale (MARS-5), measuring medication adherence. A binary logistic regression model was constructed to identify variables associated with adherence levels.Results: The study enrolled 400 diabetic patients (females =68.8%). While most of the participants (70.3%) reported high adherence levels, results revealed a window for health literacy improvement as the median for the JDHLQ score was 22 (ranging from 18 to 25) out of a maximum possible score of 32. More than half of the participants replied “never” to “I forget to take my medications”, followed by “I stop taking my medications for a while”.Conclusion: The binary regression model revealed that a higher JDHLQ score significantly increased the odds of a high adherence level. The significant association between improved health literacy and medication adherence necessitates the implementation of educational campaigns for enhancing literacy and hence medication adherence among patients with type 2 diabetes.Keywords: health literacy, adherence, Jordanian, diabetes mellitus, MARS-5
