A path model linking health literacy, medication self-efficacy, medication adherence, and glycemic control. Issue 11 (November 2018)

• Record Type: Journal Article
• Authors: Huang, Yen-Ming; Shiyanbola, Olayinka O.; Chan, Hsun-Yu
• Is Part Of: Patient education and counseling. Volume 101:Issue 11(2018)
• Page Start: 1906
• Page End: 1913
• Publication Date: 2018-11
• Subjects: Health literacy -- Document literacy -- Numeracy -- Self-efficacy -- Medication adherence -- Diabetes; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2018.06.010
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Medication self-efficacy mediates the relationship between numeracy and medication adherence. Individuals with higher numeracy skills may develop a greater level of medication self-efficacy. Greater self-efficacy may result in a higher diabetes medication adherence and a lower hemoglobin A1c. Improvement in numeracy skills and self-efficacy is recommended to enhance medication adherence. Abstract: Objective: To investigate whether medication self-efficacy moderates or mediates the relationship between health literacy and medication adherence. To propose a path model that illustrates the interrelated relationship between health literacy, medication self-efficacy, medication adherence, and hemoglobin A1c (HbA1c). Methods: This cross-sectional study was performed via a face-to-face survey. Factors that may influence medication adherence and HbA1c were identified from the literature review. One hundred and seventy-four participants included were ≥20 years old with diagnosed type 2 diabetes, understood English, and were prescribed at least one oral diabetes medicine. During clinic visits, a questionnaire was administered to evaluate health literacy, medication self-efficacy, and medication adherence. HbA1c values were obtained from electronic medical records. Path analyses were conducted for data analysis. Results: Medication self-efficacy mediated but did not moderate the relationship between numeracy and diabetes medication adherence. Participants with higher numeracy skills may develop a greater level of medication self-efficacy, which in turn may result in a higher level of diabetes medication adherence and a lower level of HbA1c. Conclusion: Enhancing patients' medication self-efficacy and numeracy skills may be imperative in intervention programs to improve diabetes medication adherence. Practice implications: An improvement in numeracy skills and medication self-efficacy is recommended to enhance diabetes medication adherence.