Article type
Abstract
"Background:
Multimorbidity, understood as the concurrent presence of two or more chronic conditions in an individual, is emerging worldwide as a public health challenge. Health literacy (HL) may be an essential factor associated with the development of multimorbidity. Research underlines the role of HL as a mediator in the association between socioeconomical status and health outcomes. And so, if addressed, it could potentially compensate for the effect of other socio-economical determinants related to health inequalities. Thus, a systematic review was done to assess the role of HL in multimorbidity.
Objective: To examines the existing literature regarding HL levels, their association with multimorbidity, and the underlying mechanisms behind said association.
Method: Databases such as MEDLINE, EMBASE, CINAHL and Science Direct were searched for articles published between Jan 1st,2000-August 31st,2023 using a systematic search strategy. Any primary study conducted in adults, regardless of setting, where HL levels and multimorbidity among the participants were reported were included. No language restrictions were used. Two authors independently extracted data and assessed the bias using JBI critical appraisal tool.
Results: We included a total of 48 studies (37 quantitative studies, 2 qualitative studies, and 1 mixed method study), representing 223,300 participants. The pooled mean score using HL questionnaire-9(HLQ-9) revealed limited HL(Table-1). Based on our analysis of the 3 articles using the HLQ-9 (n = 31,228) [Pooled OR 2.59 (95%CI 1.44,4.65)] and the 3 articles using the health literacy survey questionnaire-European Union tool (n = 35,358) [OR 1.14 (95%CI 1.06-1.24)], we found that people with limited HL were likely to have multiple conditions.(fig-1) Of three articles studying the underlying mechanisms behind this association, one reported that self-efficacy is able to mediate the association between HL and multimorbidity. In addition, substantial literature identified a set of factors that may influence this association: 1) Individual-level factors, and 2) Healthcare provider/Organizational-level factors. Finally, of the only 2 articles to study the effectiveness of HL-related interventions, both reported an improvement on clinical outcomes after the intervention.
Conclusions: Our review demonstrated a consistent association between HL and multimorbidity, indicating that people with lower HL levels are more likely to have multimorbidity.
"
Multimorbidity, understood as the concurrent presence of two or more chronic conditions in an individual, is emerging worldwide as a public health challenge. Health literacy (HL) may be an essential factor associated with the development of multimorbidity. Research underlines the role of HL as a mediator in the association between socioeconomical status and health outcomes. And so, if addressed, it could potentially compensate for the effect of other socio-economical determinants related to health inequalities. Thus, a systematic review was done to assess the role of HL in multimorbidity.
Objective: To examines the existing literature regarding HL levels, their association with multimorbidity, and the underlying mechanisms behind said association.
Method: Databases such as MEDLINE, EMBASE, CINAHL and Science Direct were searched for articles published between Jan 1st,2000-August 31st,2023 using a systematic search strategy. Any primary study conducted in adults, regardless of setting, where HL levels and multimorbidity among the participants were reported were included. No language restrictions were used. Two authors independently extracted data and assessed the bias using JBI critical appraisal tool.
Results: We included a total of 48 studies (37 quantitative studies, 2 qualitative studies, and 1 mixed method study), representing 223,300 participants. The pooled mean score using HL questionnaire-9(HLQ-9) revealed limited HL(Table-1). Based on our analysis of the 3 articles using the HLQ-9 (n = 31,228) [Pooled OR 2.59 (95%CI 1.44,4.65)] and the 3 articles using the health literacy survey questionnaire-European Union tool (n = 35,358) [OR 1.14 (95%CI 1.06-1.24)], we found that people with limited HL were likely to have multiple conditions.(fig-1) Of three articles studying the underlying mechanisms behind this association, one reported that self-efficacy is able to mediate the association between HL and multimorbidity. In addition, substantial literature identified a set of factors that may influence this association: 1) Individual-level factors, and 2) Healthcare provider/Organizational-level factors. Finally, of the only 2 articles to study the effectiveness of HL-related interventions, both reported an improvement on clinical outcomes after the intervention.
Conclusions: Our review demonstrated a consistent association between HL and multimorbidity, indicating that people with lower HL levels are more likely to have multimorbidity.
"