Factors Associated with Patients' Understanding of Their Preadmission Medication Regimen

1Vanderbill University, Nashville, TN
2Vanderbilt University, Nashville, TN
3Vanderbilt University, Nashville, TN
4Belmont University, Nashville, TN
5Vanderbilt University, Nashville, TN
6Brigham &
Women's Hospital, Boston, MA

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 82


Patients' ability to accurately report their preadmission medication regimen is a vital basis for medication reconciliation in the hospital. Understanding of the medication regimen may also affect postdischarge adherence and medication safety. We examined the effect of health literacy, cognitive function, number of medications, and other factors on patients' understanding of their preadmission medication regimen at 2 large hospitals.


Patients who enrolled in the Pharmacist Intervention for Low Literacy in Cardiovascular Disease (PILL‐CVD) study provided at baseline an assessment of health literacy (short Test of Functional Health Literacy in Adults), cognitive function (MiniCog), and sociodemographic information. A medication understanding score was computed based on patients' ability to provide the indication (1 point), strength (1/2 point), number of units/tablets per dose (½ point), and frequency (1 point) for up to 5 prescription medications selected at random from their preadmission medication list. Scores ranged from 0 to 3, with 3 indicating better understanding. We used proportional odds logistic regression to analyze the independent association of health literacy, cognitive function, number of preadmission medications, and other patient characteristics on medication understanding scores.


Patients (n = 654) had a mean age of 60.9 years, 58.7% were male, and 77.6% were white. Many (20.9%) had marginal or inadequate health literacy. The median number of prescription preadmission medications was 8 [interquartile range (IQR), 5–11]. The median medication understanding score was 2.5 (IQR, 2.2–2.8). Medication understanding scores were significantly higher among patients with adequate versus marginal/inadequate health literacy [median (IQR) = 2.6 (2.3–2.8) vs. 2.2 (1.8–2.5), P < 0.0001]. In multivariable analyses, low health literacy and being prescribed more preadmission medications were highly associated with lower medication understanding scores, P < 0.0001 for each. Black race, male sex, and impaired cognitive function were also independently associated with lower scores, P < 0.05 for each, On the 36‐point health literacy measure, for each 1‐point increase in health literacy, patients had 5% higher odds of medication understanding.


Patients' health literacy and number of prescribed medications are highly and significantly related to their understanding of the preadmission medication regimen, after adjustment for numerous other factors. Cognitive function, race, and sex are also significantly associated with medication understanding. Clinicians should be aware of these factors when taking a medication history, performing medication reconciliation, and counseling patients about safe and effective medication use.

Author Disclosure:

S. Kripalani, PictureRx, LLC, consultant, equity interest; C. Roumie, none; S. Eden, none; M. Marvanova, none; C. Cawthon, none; J. Schnipper, none.

To cite this abstract:

Kripalani S, Roumie C, Eden S, Marvanova M, Cawthon C, Schnipper J. Factors Associated with Patients' Understanding of Their Preadmission Medication Regimen. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 82. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/factors-associated-with-patients-understanding-of-their-preadmission-medication-regimen/. Accessed May 23, 2019.

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