Association of health literacy, medication beliefs, and illness perception among older adults with hypertension: a community-based study

BACKGROUND: Health literacy, medication beliefs, and illness perception significantly influence self-care among older adults patients with hypertension. However, the relationship between these factors has not been precisely established in this population. This study aimed to examine the associations of health literacy with medication beliefs and illness perception among older adults with hypertension. METHODS: This cross-sectional study was conducted among 475 hypertensive older adults in Khorramabad City, Iran. Participants were selected using a multistage random sampling method. Data were collected using demographic information questionnaire, the Health Literacy for Iranian Adults (HELIA) questionnaire, Beliefs about medicines questionnaire (BMQ), and Brief Illness Perception Questionnaire (BIPQ). Data were analyzed using SPSS 23 software, by independent t-tests, analysis of variance, Pearson correlation coefficient, and regression analysis. A p-value less than 0.05 was considered significant. RESULTS: The mean scores (with standard deviations) for health literacy, medication beliefs, and illness perception among the older adults were 57.82 (17.32), 75.14 (6.02), and 38.36 (8.89), respectively. The findings indicated a significant positive correlation between health literacy (overall and across all dimensions) and necessity, overall benefit, and necessity-concern subtraction score (P < 0.001). Conversely, a significant negative correlation was found between health literacy (overall and all dimensions) and concern, overall loss, overall misuse, and illness perception. The regression analysis identified a significant positive relationship between necessity-concern and health literacy (P < 0.001). However, the relationship between illness perception and health literacy was inverse and non-significant (P = 0.158). CONCLUSION: The findings indicate that many older individuals face challenges with health literacy, which is closely tied to their perceptions of diseases and beliefs about medications. Therefore, in addition to developing educational programs to improve health literacy, it is crucial to address and correct negative beliefs about medications and perceptions of diseases.