Medication literacy and its associated factors among middle-aged and older patients with comorbid coronary heart disease and type 2 diabetes mellitus: a cross-sectional study

Abstract

To assess medication literacy among middle-aged and older patients with comorbid coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM). A cross-sectional survey was conducted using convenience sampling. From October 2024 to May 2025, 260 hospitalized middle-aged and older patients with comorbid CHD and T2DM were recruited from a tertiary Grade A hospital in Chongqing, China. Data were collected using a general information questionnaire, the Medication Literacy Self-Assessment Scale for Patients with Comorbid Coronary Heart Disease and Diabetes, the Social Support Rating Scale, the Self-Efficacy for Appropriate Medication Use Scale, and the Patient Participation in Medication Decision-Making Scale. Descriptive statistics, univariate analysis, Pearson correlation analysis, and hierarchical linear regression analysis were performed. A total of 254 valid questionnaires were included in the final analysis. The mean medication literacy score was 74.05 ± 12.23. Hierarchical linear regression analysis showed that participation in medication decision-making, social support level, educational level, self-efficacy for appropriate medication use, place of residence, and the ability to understand drug instructions were significantly associated factors of medication literacy (all p  < 0.05). Medication literacy among middle-aged and older patients with comorbid CHD and T2DM has room for further improvement. It was associated with factors across individual, social, cognitive and functional, and healthcare system levels. Individualized interventions and multilevel support systems should be developed to improve medication literacy and promote medication safety in this population.