Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Jul;99(7):1079-1086.
doi: 10.1016/j.pec.2016.01.020. Epub 2016 Feb 1.

Health literacy and adherence to medical treatment in chronic and acute illness: A meta-analysis

Tricia A Miller  1
Affiliations
Review

Health literacy and adherence to medical treatment in chronic and acute illness: A meta-analysis

Tricia A Miller. Patient Educ Couns. 2016 Jul.

Abstract

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.

Keywords: Compliance; Health literacy; Health literacy interventions; Meta-analysis; Patient adherence.

PubMed Disclaimer

Figures

Figure 1
Figure 1
PRISMA flow diagram
See this image and copyright information in PMC

References

    1. Vermeire E, Hearnshaw H, Van Royen P, et al. Patient adherence to treatment: Three decades of research: A comprehensive review. J Clin Pharm Ther. 2001;26:331–342. - PubMed
    1. Modi AC, Quittner AL. Barriers to treatment adherence for children with cystic fibrosis and asthma: What gets in the way? J Pediatr Psychol. 2006;31:846–858. - PubMed
    1. DiMatteo MR, Haskard-Zolnierek KB, Martin LR. Improving patient adherence: A three-factor model to guide practice. Health Psychol Rev. 2012;6:74–91.
    1. DiMatteo MR. Social support and patient adherence to medical treatment: A meta-analysis. Health Psychol. 2004;23:207–218. - PubMed
    1. Haskard-Zolnierek KB, DiMatteo MR. Physician communication and patient adherence to treatment: A meta-analysis. Med Care. 2009;47:826–834. - PMC - PubMed

MeSH terms