Medication Literacy and Medication Adherence

In a world of complicated medical terms and prescription instructions, it’s easy to get overwhelmed. Understanding what medications to take, when to take them, and how to take them for improved health outcomes is an important aspect of health literacy.  

Key Terms to Know:

• Health Literacy is your ability to access, understand and use health information and services to guide decisions about your health.
• Medication Literacy is a type of health literacy that includes your ability to review, communicate, and process information about your medicines. This helps you make well-informed decisions about the medicines you take and how they affect your health.
• Medical Adherence refers to whether you are taking your prescription(s) correctly and continue to take them as long as you have decided with your healthcare provider. This includes taking the correct amount or dosage at the correct time.
• Medication Nonadherence is not taking your medication correctly as prescribed. This includes taking the wrong dosages, at the wrong times, or for the wrong length of time. Nonadherence can be intentional (on purpose) or unintentional (not on purpose).

The Importance of Medication Literacy

Lower levels of medication literacy can have negative impacts on health. For example, older adults who take many medications and have lower medical literacy rates are at risk for poorer health outcomes, which can even include death.

5 Main Reasons for Medication Nonadherence:

1. Patient factors, such as having low vision
2. Conditions, such as having a long-term disease without active symptoms to remind you to take your medicines
3. Therapy, including having a complex treatment plan with many side effects
4. Health system, including having a poor relationship with your healthcare provider
5. Social and economic factors, such as low literacy levels, high medication costs, and a lack of social support

Medication Literacy Challenges

It can be very hard to take medicines correctly. There are many skills you need to use, including understanding measurements, reading and understanding prescription labels, and keeping track of the active ingredients in your medicines. Even if you have mastered these skills, the communication from healthcare providers about medicines is not always clear.

Measuring Dosages

• Caregivers must measure specific dosages of medications for children based on their age or weight. If you do not have strong numeracy or math skills, you could give a wrong and potentially dangerous dose to your child.
• The more numbers included in a prescription label, the more likely you are to get the dosage wrong. For example, labels like ‘1 teaspoon, 3 times a day, for 7 days can cause wrong interpretations and confusion.

Understanding Prescription Labels

• Prescription labels that include time intervals, like ‘every 6 hours, and specific times of the day, like 6 am and 9 pm are often difficult to follow. These either require strong numeracy skills or don’t consider if the times fit with your daily life.
• Some labels have small fonts, hidden warning signs, and missing drug names.
• If you have limited English proficiency, language barriers may make it even harder to understand prescription labels that aren’t in your preferred language.

Keeping Track of Active Ingredients

• Active ingredients are the most important ingredients that are responsible for the effect of the medicine. People may take an unsafe amount of a certain active ingredient without realizing it, especially when taking medicines that are available over the counter or without a prescription.
• The common pain and fever medicine ingredient acetaminophen, for example, is an active ingredient in hundreds of over-the-counter medicines. Taking too much of this ingredient can cause serious liver damage and leads to thousands of hospitalizations per year.

How Healthcare Providers Can Help

Here are a couple of ways your healthcare provider can make it easier for you to take your medicines correctly. 

Teach-Back & Addressing Fears

In a US Pharmacist journal study, using simple terms and testing understanding through a ‘teach-back’ technique helped adherence rates for patients. The teach-back technique asks patients to explain the treatment plan to the provider, so the provider can ensure they fully understand it. 

Simplifying Schedules

Providers can also make the labeling of medications simpler by using a Universal Medication Schedule (UMS). This label helps specify when patients need to take medicines in an easier way using words like morning, noon, evening, and at bedtime. This schedule can also help you understand how your medication schedule fits into your daily life. 

Ways to Help Take Your Medicines Correctly

• Talk to your healthcare provider about how to simplify your medicine routine. Asking for clarifications and simplifying your medicine routine may make it easier to follow in the long run. It can also help you to avoid any potential negative effects from taking them incorrectly.
• Read medication labels and instructions carefully. Know what active ingredients are in your medicines and how much is safe to take. Read the label to see what side effects to look out for. Ask your healthcare provider if you have any questions about the instructions.
• Link taking your medicines to daily activity. You can plan to take medicines after an activity, like a daily walk, to help make taking them a habit.
• Keep a medicine calendar and a timer to remind you when your next dose is due. For example, you can use a pill container with the correct dosages every day and refill it every week. You can also set electronic reminders or alarms on your phone.
• Ask your pharmacy about setting up automatic refills. You can have your medicines ready when your current prescription finishes so you don’t miss any doses.
• Be prepared before a trip. If you’re traveling, bring enough medicine to last you the course of the trip and extra in case travel plans unexpectedly change. Keep your medicines in your carry-on bags for easy access.

Additional Information:

• Why You Need to Take Your Medications as Prescribed or Instructed (FDA.gov)
• Stop -- Learn -- Go -- Tips for Talking with Your Pharmacist to Learn How to Use Medicines Safely (FDA.gov)
• Medication Safety (HealthyChildren.org)
• Safe Use of Medicines for Older Adults (National Institute on Aging)
• Adverse Drug Events in Adults (CDC.gov)