SynthesisBMJ open2024
Unravelling the role of health literacy among individuals with multimorbidity: a systematic review and meta-analysis.
Synthesis in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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
9 citing papers in PubMed.
- Shared Decision-Making with Patients with Multimorbidity and Limited Health Literacy: The Importance of Values Clarification.Journal of general internal medicine · 2026Article
- From Correlation to Action: Advancing Health Literacy and Self-Care Research in Chronic Disease.Journal of clinical nursing · 2026Article
- Compensatory network capital: negative and ambivalent ties in the conversion of health literacy into action.Health promotion international · 2026Article
- Patterns of multimorbidity and their association with edentulism: the moderating role of health literacy in the Lifelines Cohort.European journal of public health · 2026Article
- Co-Creating Organisational Health Literacy: Formative Evaluation and Feasibility Testing of OHL-Act.International journal of environmental research and public health · 2026Article
- Cultural adaptation and psychometric validation of the Health Literacy Instrument for Adults with Tuberculosis (HELIA-TB) in India.PloS one · 2026Article
- Analysis of influencing factors and urban-rural difference decomposition of mental health literacy among residents in Chongqing, Southwest China: a large-scale multistage random sampling survey.Frontiers in public health · 2026Article
- Digital Health Literacy of Adolescents and Its Association with Vaccination Literacy: The First Evidence from Lithuania.Epidemiologia (Basel, Switzerland) · 2025Article
- COPD Management: Bridging the Gap Between Living Well and Living Longer.International journal of chronic obstructive pulmonary disease · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine existing literature regarding health literacy levels and their association with multimorbidity and the potential underlying mechanisms behind the said association.
designSystematic review and meta-analysis. DATA SOURCES: The databases MEDLINE, EMBASE, CINAHL and Science Direct were searched for articles published between 1 January 2000 and 31 October 2023 using a systematic search strategy. ELIGIBILITY CRITERIA: Included were all primary studies conducted in people over 18 years old with data on health literacy levels and the presence of multimorbidity. No language restrictions were used. DATA EXTRACTION AND SYNTHESIS: Two authors independently extracted data and assessed the bias using the Joanna Briggs Institute critical appraisal tools.
resultsWe included a total of 39 studies (36 quantitative, two qualitative and one mixed-method), representing 154 337 participants. We found a 32% proportion of limited health literacy among individuals with multimorbidity. Analysis of three articles using the Health Literacy Questionnaire tool (n=31 228) (Pooled OR 2.88 (95% CI 1.92 to 4.31)) and three articles using the Health Literacy Survey Questionnaire-European Union tool (n=35 358) (OR 1.16 (95% CI 1.07 to 1.25)) indicated that people with limited health literacy were likely to have multiple conditions. One of three articles studying underlying mechanisms reported that self-efficacy mediates the association between health literacy and multimorbidity. Additionally, substantial literature identified education and income as the most consistent determinants of health literacy among individuals with multimorbidity. Of the only two articles studying the effectiveness of health literacy-related interventions, both reported an improvement in clinical outcomes after the intervention.
conclusionsOur review demonstrated a consistent association between health literacy and multimorbidity, indicating that people with lower health literacy levels are more likely to have multimorbidity. More evidence is needed regarding the effect of health literacy interventions on multimorbidity. PROSPERO REGISTRATION NUMBER: CRD42022301369.
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