Parmar Jinal, El Masri Aymen, MacMillan Freya, McCaffery Kirsten, Arora Amit
School of Health Sciences, Western Sydney University, Campbelltown, NSW, 2560, Australia.
Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.
BMC Public Health. 2025 Jan 20;25(1):222. doi: 10.1186/s12889-024-20734-z.
For people living with Type 2 Diabetes Mellitus (T2DM), achieving optimal health outcomes requires optimal self-management and adherence to medical treatment. While some studies suggest an association between poor medication adherence and lower levels of health literacy, the evidence for this association remains inconclusive. This systematic review aimed to synthesise the evidence on the association between health literacy and medication adherence among adults from ethnic minority backgrounds living with T2DM.
Medline (Ovid), The Cochrane Library, Embase (Ovid), PsycInfo (EBSCO), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO) were searched systematically for peer-reviewed literature, published until January 2024. Studies were included in this review if they assessed health literacy and medication adherence among ethnic minority people with T2DM. Two reviewers independently screened and selected the studies, extracted data from the included articles, and assessed the methodological quality of the studies. The methodological quality and bias in designing, conducting, and analysis of each study were evaluated using a standardised JBI critical appraisal tool.
Of the total 6,318 identified studies, seven studies were included in the review. The total participant sample sizes across these studies varied from 53 to 408 participants. All included studies incorporated cross-sectional design for the research, with the majority conducted in the USA. Of the seven unique studies, only one study observed a significant association between health literacy and medication adherence among people from an ethnic minority background.
Evidence on the association between health literacy and medication adherence in ethnic minority adults with T2DM is weak and inconsistent. To understand this association more clearly in ethnic minority populations and to address the disparities in cultural and linguistic considerations, well-designed studies are required.
This review is registered with PROSPERO (CRD42022328346).
对于2型糖尿病（T2DM）患者而言，实现最佳健康结局需要最佳的自我管理以及坚持药物治疗。虽然一些研究表明药物依从性差与健康素养水平较低之间存在关联，但这种关联的证据仍不确凿。本系统评价旨在综合有关T2DM的少数族裔背景成年人健康素养与药物依从性之间关联的证据。
系统检索了Medline（Ovid）、Cochrane图书馆、Embase（Ovid）、PsycInfo（EBSCO）以及护理与健康相关文献累积索引（CINAHL）（EBSCO），以查找截至2024年1月发表的同行评议文献。如果研究评估了T2DM少数族裔人群的健康素养和药物依从性，则纳入本评价。两名评价者独立筛选并选择研究，从纳入文章中提取数据，并评估研究的方法学质量。使用标准化的JBI批判性评价工具评估每项研究在设计、实施和分析中的方法学质量和偏倚。
在总共识别出的6318项研究中，有7项研究纳入了本评价。这些研究的总参与者样本量从53名到408名参与者不等。所有纳入研究均采用横断面设计进行研究，大多数研究在美国开展。在这7项独特的研究中，只有1项研究观察到少数族裔背景人群的健康素养与药物依从性之间存在显著关联。
关于T2DM少数族裔成年人健康素养与药物依从性之间关联的证据薄弱且不一致。为了更清楚地了解少数族裔人群中的这种关联，并解决文化和语言方面的差异问题，需要设计完善的研究。
本评价已在PROSPERO（CRD42022328346）注册。
