Is Health Literacy Associated With Parental Comprehension of Discharge Medications for Children With Medical Complexity?

OBJECTIVE: Children with medical complexity (CMC) are a high-risk population for many reasons including polypharmacy, which predisposes to medication errors. Parental comprehension of discharge medications is essential to reducing the risk for medication errors in CMC. The aim of this study was to determine whether parental health literacy is associated with comprehension of discharge medications among CMC. METHODS: This was an observational cross-sectional study of English- and Spanish-speaking parents (n = 60) of CMC younger than 18 years admitted to the pediatric intensive care unit or acute care floor of 2 affiliated hospitals. Surveys were self-administered at time of discharge. Newest vital sign is a validated tool that identifies patients at risk for low health literacy. A score less than or equal to 3 indicated low health literacy. Comprehension was a composite score encompassing 6 domains (medication name, indication, dose, frequency, duration, and side effects) and was measured as a continuous variable. Simple and multiple linear regression models assessed the association between health literacy and comprehension, accounting for covariates. RESULTS: The unadjusted parental comprehension score was 1.16 higher (SE 0.33) in caregivers with appropriate health literacy (P < .01). Health literacy explained 17% of the variance in comprehension. Once adjusting for income, the association between health literacy and comprehension was no longer significant (P = .05). CONCLUSION: Low parental health literacy is associated with worse comprehension of discharge medications for parents of CMC, but the relationship is confounded by income. Initiatives to improve medication comprehension with special attention to health literacy and social determinants of health may help address this problem.