Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 10, 2023
Date Accepted: Jun 26, 2024
Urban-Rural Differences in the Association of eHealth Literacy With Medication Adherence Among Older People With Frailty and Pre-Frailty: Cross-Sectional Study
ABSTRACT
Background:
With the development of science and technology and health literacy improvement, more studies have focused on frailty prevention by promoting medication adherence, emphasizing the role of eHealth literacy. However, the association between eHealth literacy and medication adherence in frail older adults has not been well studied, and it is unknown whether there are urban-rural variances in their relationship.
Objective:
This study aims to examine the relationship between eHealth literacy and medication adherence in older people with different frail status, with an emphasis on variations between rural and urban areas.
Methods:
Between November and December 2020, 4218 urban and rural community populations (≥60 years older) in China were recruited as participants using a multistage random sampling method. A face-to-face structured questionnaire survey was conducted to collect information on demographic characteristics, eHealth literacy (consisting of application, evaluation, and decision dimensions), and medication adherence. To examine how eHealth literacy is linked to medication adherence and urban-rural differences, we employed logistic regression models separately.
Results:
There were 4218 respondents, 2316 and 1902 urban and rural residents, respectively. Among pre-frail participants, a statistical association between eHealth literacy (AOR=0.98, 95% CI: 0.97-1.00) concerning application (AOR=0.98, 95% CI: 0.96-1.00), evaluation (AOR=0.93, 95% CI:0.89-0.98), as well as decision (AOR=0.88, 95% CI: 0.79-0.98) dimensions and medication adherence was only observed among urban older people. However, such statistical association was not observed among frail subjects (P>0.05). Among frail subjects, eHealth literacy dimensions concerning application (AOR=0.99, 95% CI: 0.95-1.02), evaluation (AOR=1.01, 95% CI: 0.92-1.09), and decision (AOR=1.02, 95% CI: 0.87-1.21) dimensions were not statistically linked to medication adherence among rural participants (P>0.05).
Conclusions:
The results show that there are variations between urban and rural areas in the relationship between eHealth literacy and medication adherence in non-frail and pre-frail older adults. In the future, from an eHealth literacy perspective, we could develop tailored interventions based on urban-rural differences to promote medicine adherence in this community.
Citation
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Copyright
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