Health literacy and adherence to chronic medication : a descriptive study in a primary health care clinic in the Eden District

Thesis (MFamMed)--Stellenbosch University, 2015.ENGLISH SUMMARY : Introduction: Non-communicable disease is a major cause of morbidity in South Africa. Poor adherence to long-term medication severely compromises the effectiveness of treatment. Multiple factors have been described that affect adherence, with health literacy suggested as an independent predictor of medication adherence. This study explored patients’ health literacy and adherence in a primary health care setting in the Eden district of the Western Cape Province. Methods: This was a cross-sectional observational study. Two validated questionnaires were used in a primary health clinic. The Morisky 8 item medication adherence questionnaire was used to assess participants’ adherence. To evaluate participants’ health literacy, the Adaptation of the Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R) to the South African context was used. Results: Of the total 265 patients interviewed the literacy scores were “poor” for 244 (92%) and “good” for 21 (8%). On the self-reported adherence, 204 (77%) reported “low” adherence, 61 (23%) reported “medium” adherence and none reported “good” adherence. Conclusion: Most participants had poor health literacy and poor to medium adherence to medication. Factors influencing adherence are multiple and diverse. Health literacy might improve adherence but all the factors influencing adherence need to be taken into account.AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar