THE ROLE OF HEALTH LITERACY IN THE MEDICATION ADHERENCE OF PATIENTS DIAGNOSED WITH HYPERTENSION: AN EVIDENCE-BASED REVIEW

Abstract

Introduction: Hypertension (HTN) is the most prevalent cardiovascular disease in the world. Only one in five people with HTN has the disease under control. Medication adherence plays a crucial role in controlling HTN. In a study conducted in 2008, it was found that half of patients discontinued antihypertensive medication within a year.
Purpose: Understand the role of health literacy in medication adherence in adults with HTN.
Methodology: In this review, we used the MeSH: “health literacy” AND “hypertension” AND “medication adherence”. We searched for systematic reviews (SR), randomized clinical trials, meta-analyses and articles published between 2013 and 2023, in Portuguese, English and Spanish, in the Cochrane Library and PubMed databases. We applied the PICO methodology - Population: adults (≥18 years old) with HTN; Intervention: health literacy; Comparison: non-intervention;   Outcome: medication adherence; The level of evidence and strength of recommendations were assigned based on the SORT (Strenght of Recommendation Taxonomy) classification.
Results: From the initial search, we selected 108 articles, of which 82 were excluded after reading the title or abstract. After fully reading the articles, 9 met the inclusion criteria: two SR and 7 observational studies.
Discussion/Conclusions: Of the 9 studies analyzed, three did not have statistically significant results (n=807), while 6 demonstrated a statistically significant connection (n=4094). The main limitation identified was the use of different scales to assess medication adherence and health literacy. Furthermore, the population evaluated in most studies belongs to minorities and, to date, no studies have been carried out at an European level. According to the review carried out, the evidence points to a positive impact of health literacy on medication adherence (Strength of recommendation B).