Associations of Health Literacy, Medication Adherence and Health Behavior for Delaying Kidney Progression in Patients with Chronic Kidney Disease in Stage 3-4

Abstract

Objective: To investigate the association between health literacy, medication adherence, and health behavior for delaying kidney progression among patients with chronic kidney disease (CKD) stage 3-4. Methods: A quantitative analytical cross-sectional study was conducted in 166 patients diagnosed with CKD stage 3-4 in the Nephrology Clinic at Bhumibol Adulyadej Hospital, Bangkok, during January to May 2021. Data were collected by a set of questionnaires, including the Health Literacy questionnaires for CKD stage 3-4, the Medication Adherence Scale for Thais, and the Health Behavior for Delaying Kidney Progression questionnaires developed in the study through literature review. The patients completed the questionnaire by themselves or responded to the questions read to them by the researcher. Results: Average age of participants was 65.72 ± 9.85 years. The average health literacy score was 83.17 ± 10.70 (from the full score of 108). Most patients (141 participants, 84.9%) had adequate medication adherence (score ≥ 34). The average score of health behavior for delaying kidney progression was 26.14 ± 3.95 (from the full score of 33 points). The study found health literacy was significantly associated with medication adherence (adjusted OR 1.05, p = 0.042) when educational level, monthly income, time duration diagnosed with CKD and self-efficacy to delay kidney progression, Moreover, the study identified the significant association between health literacy and health behavior for delaying kidney progression (beta coefficient = 0.143, P < 0.001). Conclusion: Health literacy was significantly associated to medication adherence and health behavior for delaying kidney progression in patients with CKD stage 3-4.