Health and medication literacy and the desire to participate in pharmacotherapy decision making - comparison of two countries

Abstract

Background: Health and medication literacy may be important factors in the outcomes of medical treatment. Similarly, shared decision making or lack of it may influence patient's behavior and adherence to medications.

Objectives: To describe health and medication literacy as well as factors associated with poor medication literacy in two different populations and secondly, to describe desire to participate in decisions concerning medications; and to assess the role of poor medication literacy in decision making.

Methods: A general population based survey in Finland (n = 8003) and in Malta (n = 2000). Health and medication literacy and the desire to participate in decision making was each measured with three statements based on the literature. Medication literacy was operationalized as understanding the instructions on package insert and ability to follow instructions on pharmacy label.

Results: Fifteen percent of the Finnish respondents and 16% of Maltese reported always or often having problems understanding package inserts, i.e., poor medication literacy. Males (p = 0.004) and respondents in the age group 65-79 years (p < 0.001) were more prone to report such poor medication literacy. Respondents in Finland (59%) and Malta (65%) reported wanting to discuss different treatment options with the doctor. The respective percentages (42% Finland, 57% Malta) were lower for discussing about the choice of medicine and for deciding about the medicine (36% and 43%, respectively). The desire to participate in deciding about the medicines was higher among females (p < 0.001) and Maltese respondents (p < 0.001). Also those with poor medication literacy more often (p < 0.001) expressed a desire to participate in deciding in the choice of medicine.

Conclusions: Medication literacy was rather low, while desire to participate in pharmacotherapy decision making was high, especially in Malta. Overall, women tended to be more willing to participate in decision making. The desire to participate in decisions was higher among persons with low medication literacy.

Keywords: Desire to participate; Finland; Health literacy; Malta; Medication; Medication literacy; Population survey.