Association Between Health Literacy and Medication-Related Burden in Older Adults with Cardiometabolic Diseases: The Mediating Role of Perceived Social Support in a Cross-Sectional Study.
- 1College of Nursing, Seoul National University, Seoul, Korea.
Abstract
Purpose
Older adults with cardiometabolic diseases (CMDs) often experience medication-related burden (MRB) in the context of long-term use of multiple medications, yet how health literacy and social support relate to this burden remains under-examined. This study aimed to examine the association between health literacy and MRB and the mediating role of perceived social support in this population.Patients and methods
In this cross-sectional study, 254 community-dwelling older adults (aged ≥65 years) with CMDs using ≥2 prescription medications were recruited from an online survey panel in South Korea between November 14 and 24, 2025. MRB, health literacy, and perceived social support were assessed using the Living with Medicines Questionnaire version 3, Short-Form Health Literacy Instrument, and Multidimensional Scale of Perceived Social Support, respectively. Multiple regression and mediation analysis (SPSS PROCESS macro, Model 4; 5000 bootstrap samples) were performed, adjusting for 10 covariates.Results
Participants' mean age was 69.83 years (SD = 3.64), and 55.12% were female. Higher health literacy (B = -1.305, p < 0.001), higher perceived social support (B = -0.324, p < 0.001), and good self-rated health (B = -10.162, p < 0.001) were associated with lower MRB (adjusted R ² = 0.394). Social support showed a statistically significant indirect effect in the tested model (indirect effect = -0.243; 95% bootstrap confidence interval [-0.418, -0.098]), accounting for 15.7% of the total effect.Conclusion
Higher health literacy and perceived social support were associated with lower MRB, with social support representing a partial pathway. These findings suggest that efforts to manage MRB may need to prioritize health literacy while also considering supportive social systems. However, given the cross-sectional design and an online panel sample that may underrepresent older adults with limited digital access, frailty, cognitive impairment, or low health literacy, causal inferences cannot be drawn; longitudinal and intervention studies are needed.
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BibTeX
@article{kim2026association,
title = {{Association Between Health Literacy and Medication-Related Burden in Older Adults with Cardiometabolic Diseases: The Mediating Role of Perceived Social Support in a Cross-Sectional Study.}},
author = {Jeongyeon Kim and Kyungmi Woo},
journal = {Patient preference and adherence},
year = {2026},
month = oct,
doi = {10.2147/ppa.s620656},
url = {https://europepmc.org/article/MED/42974465},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Association Between Health Literacy and Medication-Related Burden in Older Adults with Cardiometabolic Diseases: The Mediating Role of Perceived Social Support in a Cross-Sectional Study.
AU - Jeongyeon Kim
AU - Kyungmi Woo
PY - 2026
DA - 2026/10/29
JO - Patient preference and adherence
DO - 10.2147/ppa.s620656
UR - https://europepmc.org/article/MED/42974465
AB - Purpose Older adults with cardiometabolic diseases (CMDs) often experience medication-related burden (MRB) in the context of long-term use of multiple medications, yet how health literacy and social support relate to this burden remains under-examined. This study aimed to examine the association between health literacy and MRB and the mediating role of perceived social support in this population.Patients and methods In this cross-sectional study, 254 community-dwelling older adults (aged ≥65 years) with CMDs using ≥2 prescription medications were recruited from an online survey panel in South Korea between November 14 and 24, 2025. MRB, health literacy, and perceived social support were assessed using the Living with Medicines Questionnaire version 3, Short-Form Health Literacy Instrument, and Multidimensional Scale of Perceived Social Support, respectively. Multiple regression and mediation analysis (SPSS PROCESS macro, Model 4; 5000 bootstrap samples) were performed, adjusting for 10 covariates.Results Participants' mean age was 69.83 years (SD = 3.64), and 55.12% were female. Higher health literacy (B = -1.305, p < 0.001), higher perceived social support (B = -0.324, p < 0.001), and good self-rated health (B = -10.162, p < 0.001) were associated with lower MRB (adjusted R ² = 0.394). Social support showed a statistically significant indirect effect in the tested model (indirect effect = -0.243; 95% bootstrap confidence interval [-0.418, -0.098]), accounting for 15.7% of the total effect.Conclusion Higher health literacy and perceived social support were associated with lower MRB, with social support representing a partial pathway. These findings suggest that efforts to manage MRB may need to prioritize health literacy while also considering supportive social systems. However, given the cross-sectional design and an online panel sample that may underrepresent older adults with limited digital access, frailty, cognitive impairment, or low health literacy, causal inferences cannot be drawn; longitudinal and intervention studies are needed.
SN - 1177-889X
ER -