Pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in Serbia

Abstract Background Pharmacotherapy literacy (PTHL) is a specific ability to safely access, appraise and understand the available information concerning medication and to calculate and act accordingly. The concept of PTHL is mostly unknown for the majority of diabetes mellitus type 2 (DMT2) patients...

Full description

Bibliographic Details
Main Authors: Marija Levic, Natasa Bogavac-Stanojevic, Stana Ubavic, Dusanka Krajnovic
Format: Article
Language:English
Published: BMC 2023-09-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-023-16639-y
_version_ 1797555922521817088
author Marija Levic
Natasa Bogavac-Stanojevic
Stana Ubavic
Dusanka Krajnovic
author_facet Marija Levic
Natasa Bogavac-Stanojevic
Stana Ubavic
Dusanka Krajnovic
author_sort Marija Levic
collection DOAJ
description Abstract Background Pharmacotherapy literacy (PTHL) is a specific ability to safely access, appraise and understand the available information concerning medication and to calculate and act accordingly. The concept of PTHL is mostly unknown for the majority of diabetes mellitus type 2 (DMT2) patients in Serbia. With diabetes being one of the major public health problems in Serbia with a prevalence of 9.1%, this two-study research aims at constructing performance-based instrument and estimating the prevalence of PTHL levels and identification of predictors of low PTHL scores in patients with DMT2. Methods Multistage study was performed to adapt the existing performance–based instrument (PTHL-SR) into specific questionnaire for DMT2 population (PTHL-DM instrument). PTHL levels were assessed through cross-sectional study categorising patients into groups of low, medium, and high PTHL levels. We considered 19 predictors for low PTHL scores, from sociodemographic characteristics, health behaviours and health characteristics, access to health-related information and empowerment-related indicators. Univariate and multivariate logistic regression analyses were used to determine independent predictors of low PTHL. Results The final 15-item PTHL-DM instrument proved to have satisfactory reliability (KR20 = 0.475) and internal reliability [ICC for the whole instrument was 0.97 with 95% confidence intervals (0.95–0.99)]. Positive correlation (rho = 0.69) between PTHL-DM score (15 questions) and the total PTHL-SR score (14 questions) was also observed. It was demonstrated that the majority of 350 patients had low PTHL (62%), and only 5% high PTHL level. Mean score on PTHL-DM was 7.8 ± 2.3. Probability of low PTHL increased among smokers, patients with low interest in health and those who estimated their health as bad. Patients who used pharmacists as sourse of information were less likely to be pharmacotherapy illiterate. Combined therapy with insulin and Oral Hypoglycemic Agents was associated with higher PTHL. Conclusions Our data indicate that specific PTHL-DM tool is objective, valid, and reliable. It was found that low level of PTHL prevailed among DMT2 patients. Medication literacy is influenced by age, residence, education, and family status. Patients with better health literacy also reported better health behaviours. Different patient empowerment programs and approaches aimed at raising PTHL would be essential to improve self-management and control of this widespread chronic disease in Serbia.
first_indexed 2024-03-10T16:55:24Z
format Article
id doaj.art-dd4d259a9037452eb303e350a3d37144
institution Directory Open Access Journal
issn 1471-2458
language English
last_indexed 2024-03-10T16:55:24Z
publishDate 2023-09-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj.art-dd4d259a9037452eb303e350a3d371442023-11-20T11:10:57ZengBMCBMC Public Health1471-24582023-09-0123111410.1186/s12889-023-16639-yPharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in SerbiaMarija Levic0Natasa Bogavac-Stanojevic1Stana Ubavic2Dusanka Krajnovic3Doctoral Program of Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, Univesrity of BelgradeDepartment of Medical Biochemistry, Faculty of Pharmacy, University of BelgradeMedicines and Medical Devices Agency of Serbia (ALIMS)Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of BelgradeAbstract Background Pharmacotherapy literacy (PTHL) is a specific ability to safely access, appraise and understand the available information concerning medication and to calculate and act accordingly. The concept of PTHL is mostly unknown for the majority of diabetes mellitus type 2 (DMT2) patients in Serbia. With diabetes being one of the major public health problems in Serbia with a prevalence of 9.1%, this two-study research aims at constructing performance-based instrument and estimating the prevalence of PTHL levels and identification of predictors of low PTHL scores in patients with DMT2. Methods Multistage study was performed to adapt the existing performance–based instrument (PTHL-SR) into specific questionnaire for DMT2 population (PTHL-DM instrument). PTHL levels were assessed through cross-sectional study categorising patients into groups of low, medium, and high PTHL levels. We considered 19 predictors for low PTHL scores, from sociodemographic characteristics, health behaviours and health characteristics, access to health-related information and empowerment-related indicators. Univariate and multivariate logistic regression analyses were used to determine independent predictors of low PTHL. Results The final 15-item PTHL-DM instrument proved to have satisfactory reliability (KR20 = 0.475) and internal reliability [ICC for the whole instrument was 0.97 with 95% confidence intervals (0.95–0.99)]. Positive correlation (rho = 0.69) between PTHL-DM score (15 questions) and the total PTHL-SR score (14 questions) was also observed. It was demonstrated that the majority of 350 patients had low PTHL (62%), and only 5% high PTHL level. Mean score on PTHL-DM was 7.8 ± 2.3. Probability of low PTHL increased among smokers, patients with low interest in health and those who estimated their health as bad. Patients who used pharmacists as sourse of information were less likely to be pharmacotherapy illiterate. Combined therapy with insulin and Oral Hypoglycemic Agents was associated with higher PTHL. Conclusions Our data indicate that specific PTHL-DM tool is objective, valid, and reliable. It was found that low level of PTHL prevailed among DMT2 patients. Medication literacy is influenced by age, residence, education, and family status. Patients with better health literacy also reported better health behaviours. Different patient empowerment programs and approaches aimed at raising PTHL would be essential to improve self-management and control of this widespread chronic disease in Serbia.https://doi.org/10.1186/s12889-023-16639-yLiteracy related to medicinesPatientsDiabetes mellitus type 2Self-reported instrumentsSelf-management
spellingShingle Marija Levic
Natasa Bogavac-Stanojevic
Stana Ubavic
Dusanka Krajnovic
Pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in Serbia
BMC Public Health
Literacy related to medicines
Patients
Diabetes mellitus type 2
Self-reported instruments
Self-management
title Pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in Serbia
title_full Pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in Serbia
title_fullStr Pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in Serbia
title_full_unstemmed Pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in Serbia
title_short Pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in Serbia
title_sort pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in serbia
topic Literacy related to medicines
Patients
Diabetes mellitus type 2
Self-reported instruments
Self-management
url https://doi.org/10.1186/s12889-023-16639-y
work_keys_str_mv AT marijalevic pharmacotherapyliteracylevelandpredictorsoflowliteracyamongdiabetesmellitustype2patientsinserbia
AT natasabogavacstanojevic pharmacotherapyliteracylevelandpredictorsoflowliteracyamongdiabetesmellitustype2patientsinserbia
AT stanaubavic pharmacotherapyliteracylevelandpredictorsoflowliteracyamongdiabetesmellitustype2patientsinserbia
AT dusankakrajnovic pharmacotherapyliteracylevelandpredictorsoflowliteracyamongdiabetesmellitustype2patientsinserbia