Health literacy, treatment adherence, bone mass density and health-related quality of life among Iranian older adults with osteoporosis

ABSTRACT

There is a scarcity of studies that investigated health literacy (HL) relationships with medication adherence, bone mass density (BMD), and health-related quality of life (HRQoL) among older adults with osteoporosis. In this study, we investigated the associations among HL, adherence to treatment, BMD, and HRQoL among older adults with osteoporosis. In this cross-sectional study, a multi-stage stratified cluster sampling was employed to recruit 347 older adults with osteoporosis (60 years of age and older) in Zanjan-Iran. Data were collected applying the Iranian HL Questionnaire (IHLQ), ECOS-16 (Assessment of health-related quality of life in osteoporosis), Morisky, Green, and Levine medication adherence scale (MGL). A hierarchical linear regression analysis was used to assess the associations. About 65% of the patients had moderate HL. The results showed HL as a significant predictor for adherence to treatment (β = 0.12, p = 0.012) and bone mass density (β = 0.15, p = 0.005), but not for HRQoL. Considering the associations found between HL and medication adherence in this study, designing appropriate interventions for the elderly, including simple, clear and understandable messages seem to help promote HL and adherence to treatment. In such interventions, improving the level of access to health information and promoting the patients’ knowledge and evaluation capabilities should be considered as the core categories of the programs.

KEYWORDS:

• Health literacy
• health-related quality of life
• osteoporosis
• medication adherence

Acknowledgments

The authors thank the initial research team who provided us with the data.

Author Contributions

R.A. K.K. and S.S. collected the initial data. H.N., R.A., P.S., NGA., B.B., and S.S. were involved in the conception of the study, performed the analyses, and drafted the manuscript. H.N., V.C., and P.S. were involved in the interpretation of the results from the analyses. HN., V.C. KK., NGA. and B.B. assisted in drafting and revising the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical Approval

All procedures performed in studies involving human participants were following the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval was provided by Student Research Committee at Tabriz University of Medical Sciences.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Funding

The study was financially supported by Tabriz University of Medical Sciences, Tabriz, Iran (Grant no: 60584).