ArticleJournal of the American Pharmacists Association : JAPhA
Low-health literacy flashcards & mobile video reinforcement to improve medication adherence in patients on oral diabetes, heart failure, and hypertension medications.
Article in Journal of the American Pharmacists Association : JAPhA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 6 of them syntheses that pooled it.
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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.
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Who cites it
33 citing papers in PubMed, 6 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Unravelling the role of health literacy among individuals with multimorbidity: a systematic review and meta-analysis.BMJ open · 2024Pooled it
- The Effect of Smartphone App-Based Interventions for Patients With Hypertension: Systematic Review and Meta-Analysis.JMIR mHealth and uHealth · 2020Pooled it
- Harnessing Digital Videos to Promote Cancer Prevention and Education: a Systematic Review of the Literature from 2013-2018.Journal of cancer education : the official journal of the American Association for Cancer Education · 2020Pooled it
- mHealth education interventions in heart failure.The Cochrane database of systematic reviews · 2020Pooled it
- A systematic review of mobile health technologies to support self-management of concurrent diabetes and hypertension.Journal of the American Medical Informatics Association : JAMIA · 2020Pooled it
- How Behavior Change Strategies are Used to Design Digital Interventions to Improve Medication Adherence and Blood Pressure Among Patients With Hypertension: Systematic Review.Journal of medical Internet research · 2020Pooled it
- The effectiveness of microlearning-based education on medication adherence and health literacy in elderly individuals: a randomized controlled trial.Scientific reports · 2025Trial
- Development of a Health Behavioral Digital Intervention for Patients With Hypertension Based on an Intelligent Health Promotion System and WeChat: Randomized Controlled Trial.JMIR mHealth and uHealth · 2024Trial
- Social Media-Delivered Patient Education to Enhance Self-management and Attitudes of Patients with Type 2 Diabetes During the COVID-19 Pandemic: Randomized Controlled Trial.Journal of medical Internet research · 2022Trial
- Pharmacy-Based Approach to Improving Heart Failure Medication Use by Older Adults with Limited Health Literacy: Learning from Interdisciplinary Experience.Drugs & aging · 2018Trial
- The Relationship Between Health Literacy Level and Metabolic Control Variables in People with Diabetes: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Efficacy of a Brief Educational Video for Patients Prescribed Latent Tuberculosis Treatment: A Randomized Trial in the United States.Open forum infectious diseases · 2026Article
- Evaluating the effectiveness of training on malnutrition for Anganwadi workers in Anekal Taluk, Bengaluru Urban District.Journal of family medicine and primary care · 2025Article
- Gaps in Heart Failure Care: The Need for Effective Communication and Health Literacy-concordant Patient Education.US cardiology · 2025Review
- MedHerent: Improving Medication Adherence in Older Adults With Contextually Sensitive Alerts Through an Application That Adheres to You.Mayo Clinic proceedings. Digital health · 2024Review
- Characteristics of self-management education and support programmes for people with chronic diseases delivered by primary care teams: a rapid review.BMC primary care · 2024Review
- 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
- Pharmacist-Led Interventions for Medication Adherence in Patients with Chronic Kidney Disease: A Scoping Review.Pharmacy (Basel, Switzerland) · 2023Article
- Content Quality of YouTube Videos About Pain Management After Cesarean Birth: Content Analysis.JMIR infodemiology · 2023Article
- Student Health and Social Care Professionals' Health Literacy Knowledge: An Exploratory Study.Pharmacy (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo design and investigate a pharmacist-run intervention using low health literacy flashcards and a smartphone-activated quick response (QR) barcoded educational flashcard video to increase medication adherence and disease state understanding.
designProspective, matched, quasi-experimental design.
settingCounty health system in Dallas, Texas.
participantsSixty-eight primary care patients prescribed targeted heart failure, hypertension, and diabetes medications
interventionLow health literacy medication and disease specific flashcards, which were also available as QR-coded online videos, were designed for the intervention patients. The following validated health literacy tools were conducted: Newest Vital Sign (NVS), Rapid Estimate of Adult Literacy Medicine-Short Form, and Short Assessment of Health Literacy-50.
main outcome measuresThe primary outcome was the difference in medication adherence at 180 days after pharmacist intervention compared with the control group, who were matched on the basis of comorbid conditions, targeted medications, and medication class. Medication adherence was measured using a modified Pharmacy Quality Alliance proportion of days covered (PDC) calculation. Secondary outcomes included 90-day PDC, improvement of greater than 25% in baseline PDC, and final PDC greater than 80%. Linear regression was performed to evaluate the effect of potential confounders on the primary outcome.
resultsOf the 34 patients receiving the intervention, a majority of patients scored a high possibility of limited health literacy on the NVS tool (91.2%). The medication with the least adherence at baseline was metformin, followed by angiotensin-converting enzyme inhibitors and beta blockers. At 180 days after intervention, patients in the intervention group had higher PDCs compared with their matched controls (71% vs. 44%; P = 0.0069).
conclusionThe use of flashcards and QR-coded prescription bottles for medication and disease state education is an innovative way of improving adherence to diabetes, hypertension, and heart failure medications in a low-health literacy patient population.
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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.