@article{ce937f89aca5436c8bd32eb725327078,
title = "Mediators of the association of limited English health literacy with medication non-adherence among Singaporean elderly",
abstract = "Background: In Singapore, English is predominantly used on prescription medication labels (PMLs). However, many older Singaporeans cannot read English, and among those who read English, their English health literacy (EHL) proficiency varies. It is thus pertinent to examine the link between EHL and medication use outcomes in this population. The present research aims to address this question. Methods: Data from a national survey, on 1167 home-dwelling elderly on ⩾1 prescribed medication was analysed. The validated Health Literacy Test for Singapore was used to determine EHL. Medication non-adherence was self-reported. Path analysis examined the association between limited EHL and medication non-adherence and tested possible mediators. Results: Limited EHL was associated with medication non-adherence (total effect=0.35; p-value: 0.032), and {\textquoteleft}uncertainty in taking medications correctly due to difficulty in understanding written information on PMLs{\textquoteright} was a significant mediator (indirect effect=0.23, 95% confidence interval (0.12–0.39)). Conclusions: Elderly people with limited EHL were significantly more likely than those with adequate EHL to report that they were uncertain about taking medications correctly because they had difficulty understanding the information on PMLs and this misunderstanding contributed to medication non-adherence. Interventions focused on incorporating bilingual text and/or pictograms on PMLs may reduce uncertainty in taking medication correctly and improve medication adherence among the elderly.",
keywords = "elderly, Health literacy, medication non-adherence, pharmacy, prescription medication labels",
author = "Sumithra Suppiah and Tan, {Yi Wen} and Cheng, {Grand H.L.} and Tang, {Wern Ee} and Rahul Malhotra",
note = "Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study uses data from Wave 3 of the Panel on Health and Ageing of Singaporean Elderly (PHASE), which was funded or supported by the Singapore Ministry of Health{\textquoteright}s National Medical Research Council under its Clinician Scientist – Individual Research Grant –New Investigator Grant (NMRC-CNIG-1124-2014) and the Duke-NUS Geriatric Research Fund. This study uses data from Wave 3 of the Panel on Health and Ageing of Singaporean Elderly (PHASE), which was funded or supported by the Singapore Ministry of Health{\textquoteright}s National Medical Research Council under its Clinician Scientist – Individual Research Grant – New Investigator Grant (NMRC-CNIG-1124-2014) and the Duke-NUS Geriatric Research Fund. Funding Information: The authors would like to thank all research participants and research staff involved in this study. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study uses data from Wave 3 of the Panel on Health and Ageing of Singaporean Elderly (PHASE), which was funded or supported by the Singapore Ministry of Health?s National Medical Research Council under its Clinician Scientist ? Individual Research Grant ?New Investigator Grant (NMRC-CNIG-1124-2014) and the Duke-NUS Geriatric Research Fund. This study uses data from Wave 3 of the Panel on Health and Ageing of Singaporean Elderly (PHASE), which was funded or supported by the Singapore Ministry of Health?s National Medical Research Council under its Clinician Scientist ? Individual Research Grant ? New Investigator Grant (NMRC-CNIG-1124-2014) and the Duke-NUS Geriatric Research Fund. Publisher Copyright: {\textcopyright} The Author(s) 2020.",
year = "2020",
month = mar,
day = "1",
doi = "10.1177/2010105819899126",
language = "English",
volume = "29",
pages = "25--32",
journal = "Proceedings of Singapore Healthcare",
issn = "2010-1058",
publisher = "SingHealth Academy",
number = "1",
}