Health literacy: a barrier to pharmacist-patient communication and medication adherence.

OBJECTIVE To present a summary of the existing literature on medication nonadherence, health literacy, and use of written patient information in health care and pharmacy in particular. DATA SOURCES Searches of Medline, PubMed, and International Pharmaceutical Abstracts databases were conducted using one or more of the following terms: adherence/nonadherence, compliance/noncompliance, printed/written information, literacy, patient education, communication, and health literacy. These terms were combined with the following search terms: drug information, readability, medication/drug, patient, pharmacy/pharmacist, and prescription. References of pertinent articles were hand searched to retrieve additional articles. DATA EXTRACTION By the author. DATA SYNTHESIS Articles were grouped and summarized into three broad categories (nonadherence, health literacy, and communicating health information to patients), with an emphasis on the use of written patient information in health care and pharmacy practice in particular. The complexities inherent in nonadherence behavior, health literacy, and patient education are summarized, and suggestions for enhancing medication adherence, especially for patients with low health literacy skills, are provided. CONCLUSION The health literacy skills of American adults have not changed considerably during the previous decade. This makes use of written patient medication information in pharmacy practice problematic for some patients. Limited health literacy has been associated with poorer health, medication nonadherence, medication errors, higher medical expenses, and increased hospitalization. A need exists for identifying patients with limited health literacy and tailoring medication counseling to their needs.