Influence of functional health literacy on adherence to antidepressant treatment

Sá, Alessandro Magon de; Casagrande, Vanessa; Chagas, Eduardo Federighi Baisi; Pinheiro, Osni Lázaro

doi:10.1590/1983-1447.2022.20210299.en

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Original Article • Rev. Gaúcha Enferm. 43 • 2022 • https://doi.org/10.1590/1983-1447.2022.20210299.en copy

Influence of functional health literacy on adherence to antidepressant treatment

Influencia de la alfabetización funcional en salud en la adherencia al tratamiento con antidepresivos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To verify the influence of patients’ level of functional health literacy on adherence to antidepressant treatment.

Method

Cross-sectional study, carried out in pharmacies of the Municipal Health Department of Marília-SP, in 2020/2021. The functional literacy questionnaire verified the numerical and interpretative skills of patients, in the face of texts related to the health area. The adherence to the treatment was verified using the Morisky therapeutic adherence scale, and the data were analyzed by Anova-one-way and Kruskal-Wallis tests.

Results

A total of 150 patients participated in the study, most of them showed failures in adherence and an inadequate level of functional health literacy. However, there was no correlation between functional health literacy and treatment adherence.

Conclusion

Although no correlation was found between the variables, there is a need for greater investments in terms of adherence to the treatment, with strategies that consider the level of functional health literacy in these patients.

Keywords
Health literacy; Antidepressive agents; Medication adherence

		n	(%)
Gender	Male	27	18
Gender	Female	123	82
Age group	18-39 years	31	20.7
	40-59 years	74	49.3
	>59 years	45	30
Education Level	Elementary	70	46.7
	High School	56	37.3
	Higher Education	24	16
Family Income (Minimum wages)	Up to 2	120	80
	3 to 4	21	14
	>4	9	6

Functional Health Literacy
		Overall	Numerical	Interpretation
		M(±SD)	M(±SD)	M(±SD)
Gender	Male	59(26.1)	15.6(9)	43.8(20.1)
	Female	62.4(28)	16.3(11.8)	46(21.4)
		p=0.556	p=0.751	p=0.621
Age group	18-39 years	85.8(19.1)^a	21.2(7.3)^a	64.9(13.4)^a
	40-59 years	63.9(25.6)^b	17.8(12.8)^a	45.8(19.7)^b
	>59 years	41.8(20.7)^c	9.9(8)^b	31.8(17.1)^c
		p<0.001^*	p<0.001^*	p<0.001^*
Education Level	Elementary	45.7(22.6)^a	11.9(10.3)^a	34.2(17.7)^a
	High School	73.9(23.7)^b	18.6(9.7)^b	54.6(18.7)^b
	Higher Education	80.5(23.8)^b	22.8(13.1)^b	57.6(19.4)^b
		p< 0.001⁺	p< 0.001⁺	p< 0.001⁺
Family Income (Minimum wages)	Up to 2	58.7(27.6)^a	15.1(10.7)	43.5(21.3)^a
	3 to 4	69.3(27)	20.1(14.9)	49.2(20.4)
	>4	85(13.5)^b	21(7)	64(8.3)^b
		p=0.009^*	p=0.076⁺⁺	p=0.028^*

Morisky Test
		Mean	SD	p-value
Gender	Male	6.1	1.5	0.386
Gender	Female	5.7	1.8	0.386
Age group	18-39 years	4.7a	2	< 0.001⁺
	40-59 years	5.9b	1.7
	>59 years	6.2b	1.5
Education Level	Elementary	6.1	1.5	0.323^*
	High School	5.7	1.7
	Higher Education	5.3	2.4
Family Income (Minimum wages)	Up to 2	5.8	1.7	0.463⁺⁺
	3 to 4	6.1	1.7
	>4	5.2	2.8
Treatment time	Up to 5 years	5.8	1.9	0.524
	6 to 10 years	5.4	1.4
	> 10 years	5.9	1.6

	Morisky		Degree of adherence^**
	r	p-value	R	p-value
Overall FHL	-0.035	0.666	0.003	0.975
Numerical FHL	-0.031	0.707	0.032	0.700
Interpretation FHL	-0.028	0.733	-0.008	0.921
Functional Literacy Level*	-0.036	0.665	0.049	0.549

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[1] Corresponding author
Alessandro Magon de Sá Email: alessandrocas@gmail.com