SynthesisBMC public health2015
The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review.
Synthesis in BMC public health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 37 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 6 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Caries and Socioeconomic Factors in Adults (19-60 Years Old): An Updated Systematic Review of Observational Studies.International journal of environmental research and public health · 2026Pooled it
- Exploring the mechanism of self-management: the role of social support, self-efficacy, and health literacy based on meta-analytic structural equation modeling.BMC public health · 2025Pooled it
- Health literacy and medication adherence in adults from ethnic minority backgrounds with Type 2 Diabetes Mellitus: a systematic review.BMC public health · 2025Pooled it
- Self-reported health literacy and medication adherence in older adults: a systematic review.BMJ open · 2021Pooled it
- Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review.BMC geriatrics · 2021Pooled it
- A Systematic Review of Traditionally Used Herbs and Animal-Derived Products as Potential Analgesics.Current neuropharmacology · 2021Pooled it
- Comparative adherence to weekly oral and quarterly intravenous bisphosphonates among patients with limited heath literacy who sustained distal radius fractures.Journal of bone and mineral metabolism · 2018Trial
- Effects on Engagement and Health Literacy Outcomes of Web-Based Materials Promoting Physical Activity in People With Diabetes: An International Randomized Trial.Journal of medical Internet research · 2017Trial
- Lay Health Trainers Supporting Self-Management amongst Those with Low Heath Literacy and Diabetes: Lessons from a Mixed Methods Pilot, Feasibility Study.Journal of diabetes research · 2016Trial
- Estimating hypertension medication adherence among adults using linked Belgian health interview survey and administrative pharmacy refill data.BMC public health · 2026Article
- Access and Perceived Quality of Care in US Adults with Multiple Chronic Conditions: MEPS 2019-2021.Journal of general internal medicine · 2026Article
- Health Literacy and Medication Adherence Among Low-Income Older Adults in the Inner Center of Portugal: A Questionnaire-Based Study.Healthcare (Basel, Switzerland) · 2025Article
- Review
- How perceived risk of recurrence strengthens health management awareness in stroke patients: the chain mediating role of risk fear and health literacy.Frontiers in public health · 2025Article
- The mediating role of health awareness in the relationship between health information behavior and health outcomes among the older adults.Frontiers in public health · 2025Article
- Motivational Interviewing as a Tool to Increase Motivation and Adherence to a Long COVID Telerehabilitation Intervention: Secondary Data Analysis from a Randomized Clinical Trial.Psychology research and behavior management · 2024Article
- Article
- Content and Clinical Validation of the Nursing Outcome "Health Literacy Behaviour": A Validation Protocol.Healthcare (Basel, Switzerland) · 2023Article
- Medication Adherence and Health Literacy in Patients with Heart Failure: A Cross-Sectional Survey in Iran.Health literacy research and practice · 2022Article
- Effect of Educational Program Based on Health Literacy Index on Self-Care Ability Among Older Adults: A Randomized Clinical Trial.International journal of preventive medicine · 2022Article
Corrections and comments
- Erratum issuedErratum to: The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review.2015 · deWinter, Andrea F [corrected to de Winter, Andrea F]
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundLow health literacy is a common problem among older adults. It is often suggested to be associated with poor adherence. This suggested association implies a need for effective adherence interventions in low health literate people. However, previous reviews show mixed results on the association between low health literacy and poor adherence. A systematic meta-review of systematic reviews was conducted to study the association between health literacy and adherence in adults above the age of 50. Evidence for the effectiveness of adherence interventions among adults in this age group with low health literacy was also explored.
methodsEight electronic databases (MEDLINE, ERIC, EMBASE, PsycINFO, CINAHL, DARE, the Cochrane Library, and Web of Knowledge) were searched using a variety of keywords regarding health literacy and adherence. Additionally, references of identified articles were checked. Systematic reviews were included if they assessed the association between health literacy and adherence or evaluated the effectiveness of interventions to improve adherence in older adults with low health literacy. The AMSTAR tool was used to assess the quality of the included reviews. The selection procedure, data-extraction, and quality assessment were performed by two independent reviewers. Seventeen reviews were selected for inclusion.
resultsReviews varied widely in quality. Both reviews of high and low quality found only weak or mixed associations between health literacy and adherence among older adults. Reviews report on seven studies that assess the effectiveness of adherence interventions among low health literate older adults. The results suggest that some adherence interventions are effective for this group. The interventions described in the reviews focused mainly on education and on lowering the health literacy demands of adherence instructions. No conclusions could be drawn about which type of intervention could be most beneficial for this population.
conclusionsEvidence on the association between health literacy and adherence in older adults is relatively weak. Adherence interventions are potentially effective for the vulnerable population of older adults with low levels of health literacy, but the evidence on this topic is limited. Further research is needed on the association between health literacy and general health behavior, and on the effectiveness of interventions.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.