Assesment of health literacy and therapeutic adherence among patients with hypertension

Abstract

Introduction: High prevalence of hypertension is a significant public health problem in both developed and developing countries. The knowledge and skills that exert their effect through health-conscious behavior as part of health education play a significant role in itsprevention. The aim of our study was to assess health education, therapy loyalty, and health behavior of people with hypertension over the age of 45 that are part of health education.
Methods: Our cross-sectional, quantitative, descriptive study was conducted between February and June 2019 using a questionnaire survey. Patients over 45 years of age diagnosed with hypertension living in Kaposvár were included in the study using simple, non-random sampling (n=143). In addition to self-edited questions (sociodemographic criteria, health behavior questions), our research tool also included standardized questions applied in the international literature (Health Literacy EU Q16, Morisky Medication Adherence Scale (8-item) (MMAS)). Sample characterization was performed, and the relationships between the variables were examined using mathematical statistical tests (χ²-test, linear regression, ANOVA, independent T-test). In our studies, the significance level was determined: p<0.05.
Results: The strongest educational factor (p=0.005) proved to be the strongest differentiating factor in health education, which retained its differentiating effect in all three dimensions of health education (“Health system understanding”, “Prevention”, “Health promotion”). There were also large differences (p=0.040) between the health education of the respondents with low and high therapy loyalty (average low therapy loyalty score: 37.52; high therapy loyalty average score: 42.82). In examining the relationship between health behavior and health education, we found a correlation primarily between the “Understanding the health system” sub-index and risk behavior (smoking, alcohol consumption, physical inactivity). Risk behavior is typically associated with a lower level of health education (p<0.05).
Conclusions: Towards a study in hypertensive patients, there is a relationship between health literacy and adherence: the characteristics of high levels of health literacy are associated with a high level of adherence. The design and implementation of preventive health promotion interventions should therefore take into account the difference between cognitive abilities, especially in patients with low health knowledge, resulting in improved health literacy and more health-conscious behavior.