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Updated: Jun 23, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Association between health literacy and medication adherence in chronic diseases: a recent systematic review
Sophie Hyvert1, Anne-Laure Yailian2,3, Julie Haesebaert4,5
1Hospices Civils de Lyon, Groupement Hospitalier Centre, Hôpital Edouard Herriot, Service pharmaceutique, 69003, Lyon, France. sophie.hyvert@chu-lyon.fr.
Background:
Poor medication adherence is a serious barrier to successful chronic disease management. Previous reviews reported that low health literacy could be associated with medication non-adherence but conclusions were uncertain.
Aim:
The aim of this systematic review was to clarify the relationship between health literacy and medication adherence in adults with chronic diseases. A secondary objective was to identify the factors that influence medication adherence.
Method:
Publications analyzing the relationship between health literacy and adherence in adults with chronic diseases were identified through 6 databases between 2015 and 2020. A quality assessment was conducted in order to improve the interpretation of the relationship between health literacy and medication adherence. A narrative synthesis was then performed to describe the relationship between health literacy and medication adherence. The factors influencing medication adherence were then analyzed as a secondary outcome.
Results:
Among the 27 studies, 17 and 10 were considered to be of good and medium methodological quality, respectively. Concerning the relationship between health literacy and adherence, 14 reported a positive relationship, 1 study suggested a negative relationship, 3 found mixed results, and 9 reported not finding a relationship. Patient-related factors such as medication beliefs, self-efficacy, or medication knowledge, as well as demographic factors such as ethnic minority and incomes influence medication adherence.
Conclusion:
The present review confirms an unclear relationship between health literacy and medication adherence. Although health literacy plays a substantial role in medication adherence, other factors must be taken into account when addressing non-adherence.
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