Medication Literacy and Medication Self-Management: A Cross-Sectional Study in Hospitalised Patients (65+) With Polypharmacy

Abstract

This study aimed to examine the relationship between medication literacy and the degree to which patients are considered capable of medication self-management, the factors influencing the strength of this relationship and the factors influencing a patient's capability for medication self-management. Between January and April 2022, a cross-sectional survey was conducted on hospitalised patients (65+) with polypharmacy. Medication literacy was evaluated using the MEDication Literacy Assessment of Geriatric patients and informal caregivers (MED-fLAG). The SelfMED assessment determined a patient's capability for medication self-management. The relationship between MED-fLAG and SelfMED was explored with Pearson's r. Moderation analysis was used to explore the factors influencing the strength of the relationship between both. Linear regression explored the factors influencing SelfMED scores. In total, 169 patients participated in the study. Patients considered themselves more capable of in-hospital medication self-management (8/10 rating) compared to nurses' and physicians' opinions (6/10 rating). Interactive medication literacy scored higher (mean = 3.0) than functional (mean = 2.9) and critical medication literacy (mean = 2.8). The more medication literacy skills, the more patients were considered able for medication self-management by healthcare providers (r = 0.630, p < 0.001). Moderation analysis could not reveal any factors that significantly affected the strength of the relationship between both. Age, managing medication independently at home, the number of chronic conditions and medication literacy were significant predictors of a patient's capability for in-hospital medication self-management. This study demonstrated a rather strong correlation between the results of the MED-fLAG and the SelfMED assessment. Hence, SelfMED can be used as a stand-alone first screening instrument to determine a patient's capability for in-hospital medication self-management, without first assessing medication literacy. MED-fLAG can provide valuable insights into the medication literacy of patients considered less capable of managing their medication, allowing medication information and interventions to be tailored to the patient.

Keywords: hospitalisation; medication literacy; medication self-management; nursing; older adults; polypharmacy.

Figure 1

Nurse assessment regarding medication self-management by patients during hospitalisation.

Figure 2

The extent to which a patient is considered capable of medication self-management during hospitalisation.

Figure 3

Scatterplot of the relationship between medication literacy skills (MED-fLAG) and patients' medication self-management capacity.