Assessment and identification of potential factors influencing medication literacy in maintenance hemodialysis patients: A cross-sectional study

Abstract

Abstract Background Maintenance hemodialysis (MHD) patients have complex medication regimens that require a high level of skill to interpret medication information. However, there is currently a lack of research evaluating the ability to read and understand medication labels in Chinese MHD patients. In addition, the relationship between frailty and medication literacy among MHD patients remains unclear. Therefore, this study aims to assess the potential factors affecting medication literacy in MHD patients and to explore the relationship between frailty and medication literacy. Methods This cross-sectional study was conducted using convenience sampling in West China Hospital of Sichuan University, China. Using a general questionnaire, we collected demographic, clinical and laboratory data. Medication literacy was assessed by the Chinese Medication Literacy Scale, and frailty was assessed by the FRAIL Scale. Univariate analyses examined potential factors impacting medication literacy. An ordered logistic regression was used to analyze the relationships between medication literacy and these factors. Spearman's correlation was used to assess the association between medication literacy and frailty. Results A total of 290 MHD patients were included in the analysis. Inadequate, marginal, and adequate medication literacy was found in 56 (19.3%), 153 (52.8%), and 81 (27.9%) patients, respectively. Ordered logistic regression revealed factors impacting medication literacy: age (OR = 3.561, 95% CI = 1.769–7.171, p < 0.001 for < 65 years); education (OR = 0.116, 95% CI = 0.048–0.284, p < 0.001 for ≤ primary school education; OR = 0.294, 95% CI = 0.145–0.594, p = 0.001 for junior high school education); caregiver medication assistance (OR = 0.434, 95% CI = 0.221–0.852, p = 0.015); frailty (OR = 2.275, 95% CI = 1.120–4.621, p = 0.023 for prefrail patients); and β2-microglobulin (β2-MG) (OR = 0.990, 95% CI = 0.982–0.998, p = 0.012). Spearman's analysis showed that medication literacy was associated with frailty in MHD patients (R=-0.189, p = 0.001). Conclusions The Chinese version of the MedLitRxSE tool can help evaluate medication literacy in MHD patients. Medication literacy levels in MHD patients need improvement and differ among patient groups, such as by age, education, caregiver support, β2-microglobulin levels, and risk of frailty.