The effect of health literacy in explaining medication adherence among patients with hypertension: A cross‐sectional study of Syrian refugees in Jordan

Background Poor medication adherence is a concern among patients with hypertension. However, few studies have assessed the effect of health literacy on medication adherence among refugee patients. Aim The aim was to examine the effect of health literacy and associated factors in explaining medication adherence among Syrian refugee patients with hypertension. Methods A cross‐sectional study was used, recruiting 150 Syrian refugees with hypertension in February 2020. The Hill‐Bone scale and the Health Literacy Questionnaire were used to collect data, which were analysed using descriptive and inferential statistics. Results Participants had low levels of medication adherence and had low mean scores in eight of nine subscales of the health literacy scale, except in the appraisal of health information subscale. Factors including patient's age, marital status, the number of medications and co‐morbid diseases were significantly associated with medication adherence. Age, understanding written health information and ability to engage with healthcare providers were predictive of medication adherence. Conclusion To increase medication adherence among refugee patients with hypertension, nurses need to improve patients' health literacy and understanding of health information about their disease. Summary statement What is already known about this topic? Refugees report a higher prevalence of chronic diseases than non‐refugees due to a lack of available medications and limited access to health‐care services. Adherence to antihypertensive drugs is the cornerstone for accomplishing hypertension control. Health literacy is closely associated with better adherence to medications. What this paper adds? Syrian refugees diagnosed with hypertension showed low medication adherence. Age and level of understanding of health information were found to be factors that explained the level of medication adherence. Medication adherence was associated with the number of prescribed medications, the presence of other medical problems and marital status. The implications of this paper: To enhance medication adherence, healthcare providers, including nurses, should educate their patients about their diseases and medical regimes to enhance their health and health literacy. Further research is required to explain other personal factors, including patients' beliefs about their health and medications. Nurses, nurse managers and other healthcare professionals should develop and implement programs