Association of health literacy and medication adherence with health-related quality of life (HRQoL) in patients with ischemic heart disease

• Published in: Health and quality of life outcomes Vol. 19; no. 1; pp. 118 - 13
• Main Authors: Suhail, Muzna, Saeed, Hamid, Saleem, Zikria, Younas, Saman, Hashmi, Furqan Khurshid, Rasool, Fawad, Islam, Muhammad, Imran, Imran
• Format: Journal Article
• Language: English
• Published: London BioMed Central 13.04.2021; BMC
• Subjects: Cardiology; Cardiovascular disease; Cardiovascular diseases; Chronic illnesses; Coronary artery disease; Disease management; Disease prevention; Education; Health education; Health literacy; Heart; Heart diseases; Hospitals; HRQoL; Hypertension; Informed consent; Ischemia; Ischemic heart disease; Lahore; Low income groups; Medication adherence; Medicine; Medicine & Public Health; Mortality; Pakistan; Patient compliance; Pharmacy; Quality of life; Quality of Life Research; Questionnaires; Regression; Social classes; Variables; Lahore Pakistan; Pakistan; Medication adherence; Ischemic heart disease; Health literacy; HRQoL; Pakistan; Lahore
• ISSN: 1477-7525; 1477-7525
• DOI: 10.1186/s12955-021-01761-5

Background Medication Adherence (MA) and Health Related Quality of Life (HRQoL) are two inter-connected concepts, co-influenced by Health Literacy (HL), with significant impact on patient management and care. Thus, we aimed to estimate the association of HL and MA with HRQoL in IHD patients. Methods Cross-sectional study of 251 IHD patients recruited from Lahore over 6 months period. HL, MA and HRQoL was assessed using validated questionnaires; 16-items of HL, Morisky Green Levine Scale (MGLS) and SF-12, respectively. Chi-square for significance, logistic-regression for association and linear regression for predictions were used. Results IHD patients; males ( p  = 0.0001), having secondary—higher education ( p  = 0.0001), middle/upper class ( p  = 0.0001) and employed ( p  = 0.005) had adequate HL, and were more likely to be adherent (OR; 4.3, p  = 0.014). Both physical (PCS-12) and mental (MCS-12) component scores of HRQoL for age, gender, education, area of residence, employment and MA were significantly higher in patients with adequate HL. In multinomial regression, improved PCS-12 scores tend to be higher in subjects having secondary—higher education (OR; 3.5, p  = 0.067), employed (OR; 6.1, p  = 0.002) and adherent (OR; 2.95, p  = 0.218), while MCS-12 scores tend to be higher in patients < 65 years (OR; 2.2, p  = 0.032), employed (OR; 3, p  = 0.002) and adherent (OR; 4, p  = 0.004). In adjusted model, HL (β;0.383, p  = 0.0001) and MA (β; − 0.133, p  = 0.018) were significantly associated with PCS-12, and MCS-12 with MA (β; − 0.161, p  = 0.009) only. Conclusion Data suggested that adequate HL was significantly associated with adherence and both physical and mental dimensions of HRQoL were higher in IHD patients with adequate HL. Besides, HL and MA are independent predictors of HRQoL in IHD patients.