Educational comic book versus pamphlet for improvement of health literacy and medication adherence in older patients with type II diabetes mellitus: A randomised controlled trial

Stephanie W.Y. Yu, Desmond T.M. Tse, Jacqueline C.Y. Chui, Bo Hang Wong, Kelly K.H. Wong, Christie C. Cheng, Carilyn Y.W. Chiang, Chi Ming Lee, Henry M.H. Li, Yee Man Angela Leung

Research output: Journal article publicationJournal articleAcademic researchpeer-review

3 Citations (Scopus)

Abstract

Background. This study aimed to compare the efficacy of an educational comic book versus a pamphlet in improving the health literacy and medication adherence of older patients with type II diabetes mellitus (T2DM) in Hong Kong. Methods. Between August and October 2016, T2DM patients aged ≥50 years were recruited from the Risk Assessment and Management Clinic of Tsan Yuk Hospital. Their health literacy and medication adherence were assessed using the Chinese Health Literacy Scale for Diabetes – Multiple Choice Version (CHLSD-MC) and the eight-item Morisky Medication Adherence Scale (MMAS-8), respectively. Those with an imperfect health literacy score were randomised to the intervention or control group and to read an educational comic book or a pamphlet, respectively. Health literacy and medication adherence were reassessed immediately and 1 week after the intervention, respectively. Results. A total of 165 patients were assessed. The mean CHLSD-MC score was 59.99 out of 68; health literacy was inadequate in 13.3% of patients. The mean MMAS-8 score was 6.52 out of 8; medication adherence was low, moderate, and high in 23.0%, 50.9%, and 26.1% of patients, respectively. Among patients with an imperfect CHLSD-MC score, 88 agreed to participate and were randomised to the intervention (n=42) or control (n=46) group. After the intervention, the intervention group had a significantly higher absolute change in CHLSD-MC score (3.48 vs. 0.93, t(80)=3.28, p=0.002) but not in MMAS-8 score (0.16 vs. 0.55, t(61)= –1.55, p=0.125). Conclusion. An educational comic book is more effective than a pamphlet in improving the health literacy of older patients with T2DM in Hong Kong.
Original languageEnglish
Pages (from-to)60-64
Number of pages5
JournalAsian Journal of Gerontology and Geriatrics
Volume12
Issue number2
Publication statusPublished - 1 Dec 2017

Keywords

  • Diabetes mellitus
  • Health literacy
  • Medication adherence
  • Patient education handout
  • Type 2

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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