Tacara Soones|Jeng-Wen Lin|Michael S. Wolf|Rachel O’Conor|Melissa Martynenko|Juan P. Wisnivesky|Alex D. Federman
Pathways linking health literacy, health beliefs, and cognition to medication adherence in older adults with asthma
Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai|Northwestern University|Northwestern University|Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai|Icahn School of Medicine at Mount Sinai
backgroundlimited health literacy associated low adherence asthma controller medications among older adultsobjectivewe sought describe causal pathway linking health literacy medication adherence modeling asthma illness medication beliefs mediatorsmethodswe recruited adults aged 60 years older asthma hospital community practices new york new york chicago illinois measured health literacy medication adherence using short test functional health literacy adults medication adherence rating scale respectively used validated instruments assess asthma illness medication beliefs assessed cognition using cognitive battery using structural equation modeling modeled illness medication beliefs mediators relationship health literacy adherence controlling cognitionresultsour study included 433 patients mean age 67 68 years sample 84 women 31 nonhispanic blacks 39 hispanics 36 patients limited health literacy likely misconceptions asthma p 001 asthma medications p 001 health literacy direct effect 0089 p 001 well indirect effect adherence mediated medications concerns 0033 p 002 neither medication necessity 0044 p 138 illness beliefs 0007 p 143 demonstrated mediational role health literacy adherenceconclusionsinterventions designed improve asthma controller medication adherence older adults may enhanced addressing concerns medications addition using communication strategies appropriate populations limited health literacy cognitive impairments limited health literacy associated low adherence asthma controller medications among older adults sought describe causal pathway linking health literacy medication adherence modeling asthma illness medication beliefs mediators recruited adults aged 60 years older asthma hospital community practices new york new york chicago illinois measured health literacy medication adherence using short test functional health literacy adults medication adherence rating scale respectively used validated instruments assess asthma illness medication beliefs assessed cognition using cognitive battery using structural equation modeling modeled illness medication beliefs mediators relationship health literacy adherence controlling cognition study included 433 patients mean age 67 68 years sample 84 women 31 nonhispanic blacks 39 hispanics 36 patients limited health literacy likely misconceptions asthma p 001 asthma medications p 001 health literacy direct effect 0089 p 001 well indirect effect adherence mediated medications concerns 0033 p 002 neither medication necessity 0044 p 138 illness beliefs 0007 p 143 demonstrated mediational role health literacy adherence interventions designed improve asthma controller medication adherence older adults may enhanced addressing concerns medications addition using communication strategies appropriate populations limited health literacy cognitive impairments