The Cross-Sectional Association of Health Literacy With Medication Self-Management in the Turkish Population: A...

Health literacy (HL) is a cornerstone of effective medication use. Yet research has traditionally focused on adherence, producing inconsistent findings. Evidence linking HL to medication knowledge suggests that broader medication self-management frameworks may better capture how HL supports patients as active partners in medication use. This study examines this relationship in the Turkish healthcare system, where high medication use and diverse HL levels provide a relevant context for challenges faced by health systems worldwide.

To systematically evaluate the association between HL and medication self-management in Turkish populations. (1) examining differential associations with medication adherence versus supporting self-management behaviors, (2) explore links with specific subdomains (e.g., knowledge, safe storage), and (3) identify potential moderators such as age and region.

A systematic search of six international databases and the Turkish National Thesis Center identified 47 studies (N = 20,716). HL was assessed with validated tools. Study quality was evaluated using a modified Newcastle-Ottawa Scale. Random-effects meta-analyses estimated pooled effect sizes.

Meta-analysis revealed a significant positive association between HL and overall medication self-management (r = 0.248), with a weaker association observed for adherence alone (r = 0.192). Strongest correlations were found for medication literacy and information seeking (r = 0.372), followed by healthcare communication and support utilization (r = 0.290), safe medication handling (r = 0.173), and responsible medication access (r = 0.110). Age significantly moderated the HL-medication self-management relationship, with stronger effects among older adults.

HL supports a wide range of medication self-management behaviors, most profoundly in knowledge-based domains. Adopting a person-centered, self-management framework is essential to fully understand HL's role. The findings, contextualized within Türkiye's health system, highlight the global importance of HL-focused interventions, particularly for older populations, to support safe and effective medication use.