EHEALTH LITERACY AND MEDICATION ADHERENCE IN CHRONIC DISEASES: THE MEDIATING ROLE OF PATIENTS’ BELIEFS...
Author(s)
Yan Gequ, PhD, ? Qisen ??, Wang, MASc.
School of Healthcare Security, Shandong First Medical University, Jinan, China.
School of Healthcare Security, Shandong First Medical University, Jinan, China.
OBJECTIVES: From the perspective of health information behavior, this study aims to explore the mechanism by which eHealth literacy influences medication adherence among patients with chronic diseases, and to provide evidence for optimizing health information services and implementing targeted interventions to improve adherence.
METHODS: A cross sectional survey was conducted from November 2024 to August 2025 among 333 chronic disease patients recruited by convenience sampling from one community health center, one tertiary general hospital, and one specialized chronic disease hospital in Jinan, Shandong Province, China. Data were collected using a general information questionnaire, the Chinese version of the eHealth Literacy Scale (eHEALS), the Beliefs about Medicines Questionnaire (BMQ), and the Morisky Medication Adherence Scale (MMAS-8). Pearson correlation analysis and structural equation modeling (SEM) were used to examine relationships and test the mediating role of medication beliefs.
RESULTS: The average eHealth literacy score was 25.73±7.49, indicating a relatively low level. Factors including age, residence, education, occupation, marital status, monthly income, disease duration, health information seeking experience, and internet use frequency significantly affected eHealth literacy (P<0.05). The mean medication adherence score was 5.23±2.07, with 57.36% of patients showing poor adherence. The mean medication beliefs score was 5.19±5.20. Both medication beliefs and adherence were positively correlated with eHealth literacy. SEM showed that eHealth literacy had a total effect of 0.158 on adherence, with a direct effect of 0.076. The indirect effect via necessity beliefs was 0.018 (95% CI: 0.004-0.037), and via concerns beliefs was 0.065 (95% CI: 0.036-0.104). The total indirect effect accounted for 52.2% of the total effect.
CONCLUSIONS: eHealth literacy directly affects medication adherence and also indirectly influences adherence through medication beliefs. Interventions targeting vulnerable groups should focus on improving digital health literacy, enhancing the accessibility and credibility of health information, and cultivating rational medication beliefs to effectively improve medication adherence among chronic disease patients.
METHODS: A cross sectional survey was conducted from November 2024 to August 2025 among 333 chronic disease patients recruited by convenience sampling from one community health center, one tertiary general hospital, and one specialized chronic disease hospital in Jinan, Shandong Province, China. Data were collected using a general information questionnaire, the Chinese version of the eHealth Literacy Scale (eHEALS), the Beliefs about Medicines Questionnaire (BMQ), and the Morisky Medication Adherence Scale (MMAS-8). Pearson correlation analysis and structural equation modeling (SEM) were used to examine relationships and test the mediating role of medication beliefs.
RESULTS: The average eHealth literacy score was 25.73±7.49, indicating a relatively low level. Factors including age, residence, education, occupation, marital status, monthly income, disease duration, health information seeking experience, and internet use frequency significantly affected eHealth literacy (P<0.05). The mean medication adherence score was 5.23±2.07, with 57.36% of patients showing poor adherence. The mean medication beliefs score was 5.19±5.20. Both medication beliefs and adherence were positively correlated with eHealth literacy. SEM showed that eHealth literacy had a total effect of 0.158 on adherence, with a direct effect of 0.076. The indirect effect via necessity beliefs was 0.018 (95% CI: 0.004-0.037), and via concerns beliefs was 0.065 (95% CI: 0.036-0.104). The total indirect effect accounted for 52.2% of the total effect.
CONCLUSIONS: eHealth literacy directly affects medication adherence and also indirectly influences adherence through medication beliefs. Interventions targeting vulnerable groups should focus on improving digital health literacy, enhancing the accessibility and credibility of health information, and cultivating rational medication beliefs to effectively improve medication adherence among chronic disease patients.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
PCR1
Topic
Patient-Centered Research
Topic Subcategory
Patient Behavior and Incentives
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)