Utility of medicines information leaflets in hypertensive care in a setting with low health literacy: a cross-sectional study

Introduction: Higher levels of health literacy improve utilization of health information, medication adherence and outcomes. Few studies evaluate the utility of medicines information in hypertensive care in settings with low health literacy. Aim: To determine the level of health literacy and utility of medicines information leaflets (MIL) among hypertensive patients in public health care in Namibia.Methods: A hospital-based survey among hypertensive patients receiving care at a referral hospital in Namibia from the 8th to 29thJune 2018. Patient’s health literacy and utility of MIL were assessed using three literacy tools and a survey questionnaire. Quantitative data were analysed using descriptive statistics and qualitative thematic content analysis for factors associate with the utility of the MIL. Results: Of the 139 patients, 63% were female and the mean age was 45.7(range: 19.0-84.0) years. Over 85.6% had of low literacy skills (REALM score<44, i.e. unable to read simple health materials), 38.8% had positive SILS scores (≥2, require help to read medicines information) and 66.9% had inadequate skills for comprehension, appraisal and decision-making with regard to health information (HLSI-SF score <70%). The level of access to and utility of MIL were low, 32.4% and 34.6% respectively. The main factors associated with poor utility of the MIL were low patient health literacy, lack of guidelines on the use of MIL and MIL written in non-native languages. Conclusion: Low rates of health literacy and utility of MIL were observed among hypertensive patients in Namibia. The integration of health literacy programmes, and MIL guidelines are needed to promote utility of medicine information and improve medication adherence.