Author(s): Lupattelli A, Picinardi M, Einarson A, Nordeng H
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Abstract OBJECTIVE: Investigate the association between health literacy and perception of medication risk, beliefs about medications, use and non-adherence to prescribed pharmacotherapy during pregnancy, and whether risk perception and beliefs may mediate an association between health literacy and non-adherence. METHODS: This multinational, cross-sectional, internet-based study recruited pregnant woman between 1 October 2011 and 29 February 2012. Data on maternal socio-demographics, medication use, risk perception, beliefs, and non-adherence were collected via an on-line questionnaire. Health literacy was measured via a self-assessment scale. Mann-Whitney U test, Spearman's rank correlation, Generalized Estimating Equations and mediation analysis were utilized. RESULTS: 4999 pregnant women were included. Low-health literacy women reported higher risk perception for medications, especially penicillins (Rho: -0.216) and swine flu vaccine (Rho: -0.204) and more negative beliefs about medication. Non-adherence ranged from 19.2\% (high-health literacy) to 25.0\% (low-health literacy). Low-health literacy women were more likely to be non-adherent to pharmacotherapy than their high-level counterparts (adjusted OR: 1.30; 95\% CI: 1.02-1.66). Risk perception and beliefs appeared to mediate the association between health literacy and non-adherence. CONCLUSION: Health literacy was significantly associated with maternal health behaviors regarding medication non-adherence. PRACTICE IMPLICATIONS: Clinicians should take time to inquire into their patients' ability to understand health information, perception and beliefs, in order to promote adherence during pregnancy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
This article was published in Patient Educ Couns
and referenced in Journal of Pregnancy and Child Health