{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:46:49Z","timestamp":1792712809611,"version":"4.5.0"},"reference-count":58,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Medication adherence is a crucial factor in managing and treating chronic diseases in older adults. Health literacy (HL) skills and rational drug use (RDU) knowledge are important for individuals to make informed decisions about medication adherence behaviours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study was conducted to determine the association between medication adherence and rational drug use knowledge and health literacy in older adults residing in nursing homes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The cross\u2010sectional study was conducted with 121 older adults residing in a nursing home in Turkey. The data were collected using the Participant Information Form, the Medication Adherence Report Scale (MARS\u20105), the Rational Drug Use Scale (RDUS), and The Turkish version of the European Health Literacy Survey Questionnaire (HLS EUEU\u2010Q\u2010TR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the older adults was 69.92\u2009\u00b1\u20096.45 years and 76.9% were male. The mean score of MARS\u20105 was 21.80\u2009\u00b1\u20093.55. Among older adults, 43.8% were found to have inadequate RDU knowledge, 28.9% had inadequate HL, and 46.3% had problematic\u2010limited HL. The RDU knowledge was a statistically significant strong predictor of medication adherence (R<jats:sup>2<\/jats:sup>\u2009=\u20090.495, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The HL was a statistically significant predictor of medication adherence (R<jats:sup>2<\/jats:sup>\u2009=\u20090.037, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study found that medication adherence among older adults residing in nursing homes was moderate, RDU knowledge and HL levels were low, and medication adherence increased as RDU knowledge and HL levels increased.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.14303","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T12:28:13Z","timestamp":1736944093000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Association Between Medication Adherence and Rational Drug Use Knowledge and Health Literacy in Older Adults Residing in Nursing Homes"],"prefix":"10.1111","volume":"31","author":[{"given":"Nesrin","family":"\u0130lhan","sequence":"first","affiliation":[{"name":"Department of Nursing Faculty of Health Sciences Istanbul Medeniyet University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5612-9335","authenticated-orcid":false,"given":"Cemile","family":"Savci","sequence":"additional","affiliation":[{"name":"Department of Nursing Faculty of Health Sciences Istanbul Medeniyet University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevinc","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Dar\u00fclaceze Presidency Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"United Nations.World Population Prospects 2022 Summary of Results https:\/\/www.un.org\/development\/desa\/pd\/sites\/www.un.org.development.desa.pd\/files\/wpp2022_summary_of_results.pdf accessed March 2024."},{"key":"e_1_2_11_3_1","unstructured":"Turkish Statistical Institute (T\u00dc\u0130K)Elderly Statistics 2023 https:\/\/data.tuik.gov.tr\/Bulten\/Index?p=Istatistiklerle-Yaslilar-2023-53710 accessed April 2024."},{"key":"e_1_2_11_4_1","unstructured":"Turkish Health Institutes Presidency (T\u00dcSEB) Turkey Elderly Health Report: Current Situation Problems and Short\u2010Medium Term Solutions 2021 \u0130stanbul."},{"key":"e_1_2_11_5_1","unstructured":"Turkish Statistical Institute (T\u00dc\u0130K).Turkey Elderly Profile Survey 2023 https:\/\/data.tuik.gov.tr\/Bulten\/Index?p=Turkiye-Yasli-Profili-Arastirmasi-2023-53809 accessed July 2024."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/acel.12861"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs.2009.039818"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19074313"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2016.11.025"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2022.05.007"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2016.06.011"},{"issue":"2","key":"e_1_2_11_12_1","first-page":"90","article-title":"Association Between Health Literacy and Medication Adherence in the Elderly Population With Chronic Disease","volume":"34","author":"Ocakoglu G.","year":"2020","journal-title":"Ethiopian Journal of Health Development"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.5505\/anatoljfm.2023.83030"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2021.12.001"},{"key":"e_1_2_11_15_1","unstructured":"U.S. Food and Drug Administration (FDA) Medication Adherence: Landscape Strategies and Evaluation Methods 2019 https:\/\/www.fda.gov\/drugs\/news-events-human-drugs\/medication-adherence-landscape-strategies-and-evaluation-methods-12102019#:~:text=Medication%20adherence%E2%80%94the%20extent%20to health%20and%20reduce%20economic%20burden accessed April 2024."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S363082"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2023.11.018"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2018.06.018"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-017-0558-5"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-022-00960-w"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcgg.2015.05.001"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/agm2.12045"},{"issue":"1","key":"e_1_2_11_23_1","first-page":"497","article-title":"The Effect of Rational Drug Use on Health Perception and Drug Compliance in Chronic Diseases","volume":"14","author":"Ayik D. B.","year":"2021","journal-title":"International Journal of Caring Sciences"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.20230692"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2097-3"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.2147\/DHPS.S311926"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.46414\/yasad.759272"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1249022"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-80"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.54189\/hbd.997788"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59081401"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-055117"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.20518\/tjph.700390"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042098618754482"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2016.01.020"},{"key":"e_1_2_11_36_1","unstructured":"World Health Organization (WHO) Medication Safety in Polypharmacy. Technical Report.2019 https:\/\/www.who.int\/docs\/default-source\/patient-safety\/who-uhc-sds-2019-11-eng.pdf \u2009accessed July 2024."},{"key":"e_1_2_11_37_1","doi-asserted-by":"crossref","unstructured":"R.HorneandM.Hankins The Medication Adherence Report Scale (MARS) 2004 https:\/\/doi.org\/10.1037\/t68276-000.","DOI":"10.1037\/t68276-000"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.26650\/IUITFD.413637"},{"issue":"3","key":"e_1_2_11_39_1","first-page":"37","article-title":"Validity and Reliability of Rational Drug Use Scale","volume":"3","author":"Demirta\u015f Z.","year":"2018","journal-title":"ESTUDAM Public Health Journal"},{"key":"e_1_2_11_40_1","unstructured":"P.OkyayandF.Abac\u0131gil Turkey Health Literacy Scales Reliability and Validity Studies (ASOY\u2010TR). T.R. Ministry of Health 2016 https:\/\/toad.halileksi.net\/wp-content\/uploads\/2022\/07\/avrupa-saglik-okuryazarligi-olcegi-toad.pdf accessed December 2022."},{"key":"e_1_2_11_41_1","volume-title":"Using Multivariate Statistics","author":"Tabachnick B. G.","year":"2013"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1302_20"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.20515\/otd.465845"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-023-03768-7"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S437013"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina55050163"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.4067\/S0034-98872020000500653"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-019-1014-8"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics13071100"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.5455\/medscience.2020.04.056"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kontakt.2018.08.001"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1069174"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.824778"},{"key":"e_1_2_11_54_1","first-page":"132","article-title":"The Elderly Medication Use Behaviors That Cause Medication Non\u2010Compliance and Its Association With Their Health Literacy Levels","volume":"6","author":"\u00d6zta\u015f \u00d6.","year":"2019","journal-title":"Journal of Hacettepe University Faculty of Nursing"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-023-04072-0"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.17079\/jkgn.2023.00122"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/opn.12196"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192316001"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.20849\/ijsn.v6i4.931"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.14303","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T02:27:24Z","timestamp":1752719244000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.14303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":58,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/jep.14303"],"URL":"https:\/\/doi.org\/10.1111\/jep.14303","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"value":"1356-1294","type":"print"},{"value":"1365-2753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,15]]},"assertion":[{"value":"2024-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14303"}}