{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:20:09Z","timestamp":1784744409141,"version":"3.55.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Natural Science Foundation of Huzhou City, Zhejiang Province, China","award":["2022YZ44"],"award-info":[{"award-number":["2022YZ44"]}]},{"name":"Zhejiang Province Teaching Reform Research Project","award":["JGBA2024721"],"award-info":[{"award-number":["JGBA2024721"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    Improving medication literacy among individuals with hypertension has emerged as a significant public health issue. However, the heterogeneity of medication literacy and its association factors among young and middle-aged patients with hypertension has not yet been fully characterized. The current study aimed to identify distinct profiles of medication literacy in these population and to examine their associated factors, with the goal of informing targeted clinical interventions. A cross-sectional study was conducted with 544 consecutively recruited these hypertensive patients from two tertiary hospitals in China between July 15 and November 15, 2024. Researchers administered five validated instruments: a Demographic and Disease-Related Characteristics Questionnaire, the Revised Chinese Medication Literacy Scale for Hypertensive Patients (C-MLSHP-R), the Perceived Social Support Scale (PSSS), the General Self-Efficacy Scale (GSES), and the Brief Illness Perception Questionnaire (BIPQ). Latent profile analysis revealed three distinct profiles of medication literacy: low (35.3%), moderate (50.2%), and high (14.5%). Multivariate logistic regression further identified education level, per capita monthly household income, social support, self-efficacy, and illness perception as factors significantly associated with medication literacy (all\n                    <jats:italic>p\u2009&lt;<\/jats:italic>\n                    \u20090.05). More specifically, lower education and lower income were associated with membership in the low literacy profile, while higher social support, higher self-efficacy, and more positive illness perception characterized the high literacy group. These results suggest preliminary stratified interventions approaches, including foundational education for patients with low-literacy patients, behavioral reinforcement for those with moderate literacy, and enhanced psychosocial support for socioeconomically disadvantaged groups. However, causal interpretations are precluded by the cross-sectional design, longitudinal studies are needed to validate these findings.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0352857","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:26:52Z","timestamp":1784741212000},"page":"e0352857","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Profiles of medication literacy and associated factors among young and middle-aged hypertensive patients in China: A latent profile analysis"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5030-7209","authenticated-orcid":true,"given":"Rui","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongbin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaopu","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siwen","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaokai","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"10304","key":"pone.0352857.ref001","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S0140-6736(21)01330-1","article-title":"Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants","volume":"398","author":"NCD Risk Factor Collaboration (NCD-RisC).","year":"2021","journal-title":"Lancet"},{"key":"pone.0352857.ref002","doi-asserted-by":"crossref","first-page":"1349451","DOI":"10.3389\/fpsyg.2024.1349451","article-title":"Health literacy and self-management among middle-aged and young hypertensive patients: a parallel mediation effect of illness perception and self-efficacy","volume":"15","author":"Y Liu","year":"2024","journal-title":"Front Psychol"},{"key":"pone.0352857.ref003","article-title":"Association between high blood pressure and long term cardiovascular events in young adults: systematic review and meta-analysis","volume":"370","author":"D Luo","year":"2020","journal-title":"BMJ"},{"issue":"1","key":"pone.0352857.ref004","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s12872-025-04536-8","article-title":"Prevalence, numbers and mortality risk of hypertensive patients with depressive symptom in China","volume":"25","author":"S Li","year":"2025","journal-title":"BMC Cardiovasc Disord"},{"issue":"9","key":"pone.0352857.ref005","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.sapharm.2017.11.005","article-title":"Defining and identifying concepts of medication literacy: an international perspective","volume":"14","author":"A Pouliot","year":"2018","journal-title":"Res Social Adm Pharm"},{"issue":"6","key":"pone.0352857.ref006","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1097\/JCN.0000000000000511","article-title":"Health beliefs and medication adherence in Omanis with hypertension","volume":"33","author":"H Al-Noumani","year":"2018","journal-title":"J Cardiovasc Nurs"},{"issue":"11","key":"pone.0352857.ref007","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.3390\/healthcare10112322","article-title":"A study on types of medication adherence in hypertension among older patients and influencing factors","volume":"10","author":"S Lee","year":"2022","journal-title":"Healthcare (Basel)"},{"key":"pone.0352857.ref008","doi-asserted-by":"crossref","first-page":"957","DOI":"10.2147\/PPA.S459678","article-title":"Medication adherence of older adults with hypertension: a systematic review","volume":"18","author":"S Ruksakulpiwat","year":"2024","journal-title":"Patient Prefer Adherence"},{"key":"pone.0352857.ref009","doi-asserted-by":"crossref","first-page":"103785","DOI":"10.1016\/j.ijnurstu.2020.103785","article-title":"Instruments assessing medication literacy in adult recipients of care: a systematic review of measurement properties","volume":"113","author":"J Gentizon","year":"2021","journal-title":"Int J Nurs Stud"},{"issue":"9","key":"pone.0352857.ref010","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1037\/0003-066X.44.9.1175","article-title":"Human agency in social cognitive theory","volume":"44","author":"A Bandura","year":"1989","journal-title":"Am Psychol"},{"key":"pone.0352857.ref011","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.2147\/RMHP.S476633","article-title":"Perceived social support and health-related quality of life among hypertensive patients: a latent profile analysis and the role of delay discounting and living alone","volume":"17","author":"Y Ding","year":"2024","journal-title":"Risk Manag Healthc Policy"},{"key":"pone.0352857.ref012","doi-asserted-by":"crossref","first-page":"1506545","DOI":"10.3389\/fpubh.2025.1506545","article-title":"Latent profile and determinants of self-management behaviors among older adult patients with chronic diseases: a cross-sectional study","volume":"13","author":"YJ Shao","year":"2025","journal-title":"Front Public Health"},{"issue":"1","key":"pone.0352857.ref013","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1186\/s12877-022-03518-1","article-title":"Latent profile analysis for quality of life in older patients","volume":"22","author":"L B\u0103jenaru","year":"2022","journal-title":"BMC Geriatr"},{"issue":"4","key":"pone.0352857.ref014","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1080\/10705511.2013.824781","article-title":"Statistical power to detect the correct number of classes in latent profile analysis","volume":"20","author":"J-Y Tein","year":"2013","journal-title":"Struct Equ Modeling"},{"issue":"3","key":"pone.0352857.ref015","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1038\/s41440-024-02070-2","article-title":"Highlights of the 2024 Chinese hypertension guidelines","volume":"48","author":"J Liu","year":"2025","journal-title":"Hypertens Res"},{"key":"pone.0352857.ref016","doi-asserted-by":"crossref","first-page":"976691","DOI":"10.3389\/fcvm.2022.976691","article-title":"Psychometric properties and validation of the revised Chinese Medication Literacy Scale for Hypertensive Patients (C-MLSHP-R)","volume":"9","author":"N Qin","year":"2022","journal-title":"Front Cardiovasc Med"},{"issue":"1","key":"pone.0352857.ref017","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1186\/s12888-024-05935-5","article-title":"Social support and physical literacy in young and middle-aged patients with hypertension: the mediating effects of sense of coherence and self-efficacy","volume":"24","author":"G Ma","year":"2024","journal-title":"BMC Psychiatry"},{"key":"pone.0352857.ref018","doi-asserted-by":"crossref","first-page":"1184701","DOI":"10.3389\/fphar.2023.1184701","article-title":"Influencing factors of medication literacy among community-dwelling older adult patients with hypertension: a study based on social learning theory","volume":"14","author":"T Lu","year":"2023","journal-title":"Front Pharmacol"},{"key":"pone.0352857.ref019","doi-asserted-by":"crossref","first-page":"103445","DOI":"10.1016\/j.jvb.2020.103445","article-title":"Latent profile analysis: a review and \u201chow to\u201d guide of its application within vocational behavior research","volume":"120","author":"D Spurk","year":"2020","journal-title":"J Vocat Behav"},{"issue":"1","key":"pone.0352857.ref020","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1080\/10705511.2011.532732","article-title":"Conducting confirmatory latent class analysis using Mplus","volume":"18","author":"WH Finch","year":"2011","journal-title":"Struct Equ Modeling"},{"issue":"1","key":"pone.0352857.ref021","doi-asserted-by":"crossref","DOI":"10.1097\/CCM.0000000000004710","article-title":"Practitioner\u2019s guide to latent class analysis: methodological considerations and common pitfalls","volume":"49","author":"P Sinha","year":"2021","journal-title":"Crit Care Med"},{"issue":"4","key":"pone.0352857.ref022","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1080\/10705510701575396","article-title":"Deciding on the Number of classes in latent class analysis and growth mixture modeling: a monte carlo simulation study","volume":"14","author":"KL Nylund","year":"2007","journal-title":"Struct Equ Modeling"},{"issue":"2","key":"pone.0352857.ref023","first-page":"170","article-title":"A nomogram-based analysis on medication adherence of hypertensive patients in China","volume":"19","author":"Y Pan","year":"2025","journal-title":"Asian Nurs Res (Korean Soc Nurs Sci)"},{"issue":"1","key":"pone.0352857.ref024","doi-asserted-by":"crossref","DOI":"10.1097\/JCN.0000000000001214","article-title":"The status of medication literacy in young patients with hypertension and its relationship with medication adherence","volume":"41","author":"X Ming","year":"2026","journal-title":"J Cardiovasc Nurs"},{"issue":"5","key":"pone.0352857.ref025","article-title":"Adherence to antihypertensive therapy and its determinants: a systematic review","volume":"16","author":"PD Ferreira","year":"2024","journal-title":"Cureus"},{"issue":"1","key":"pone.0352857.ref026","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1186\/s12889-025-22798-x","article-title":"Health literacy and hypertension-related multimorbidity: unravelling the mediating role of self-management-insights from the lifelines cohort study","volume":"25","author":"L Loreto","year":"2025","journal-title":"BMC Public Health"},{"issue":"2","key":"pone.0352857.ref027","article-title":"Association between medication literacy and blood pressure control among hypertensive patients","volume":"30","author":"N Qin","year":"2024","journal-title":"Int J Nurs Pract"},{"issue":"7","key":"pone.0352857.ref028","doi-asserted-by":"crossref","first-page":"720","DOI":"10.3390\/ijerph13070720","article-title":"Medication literacy in a cohort of Chinese patients discharged with acute coronary syndrome","volume":"13","author":"Z Zhong","year":"2016","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"pone.0352857.ref029","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0317684","article-title":"Impact of health education on knowledge retention among caregivers of hypertensive patients: a prospective cross-sectional study in rural Malawi","volume":"20","author":"C Maluwa","year":"2025","journal-title":"PLoS One"},{"issue":"3","key":"pone.0352857.ref030","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s11739-019-02187-0","article-title":"The status of medication literacy and associated factors of hypertensive patients in China: a cross-sectional study","volume":"15","author":"G Ma","year":"2020","journal-title":"Intern Emerg Med"},{"issue":"10","key":"pone.0352857.ref031","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1161\/HYPERTENSIONAHA.125.24992","article-title":"Overcoming barriers to developing and implementing novel therapies for hypertension","volume":"82","author":"KA Krychtiuk","year":"2025","journal-title":"Hypertension"},{"issue":"1","key":"pone.0352857.ref032","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/s12916-025-03949-8","article-title":"Anti-hypertensive medication adherence, socioeconomic status, and cognitive aging in the Chinese community-dwelling middle-aged and older adults\u2009\u2265\u200945 years: a population-based longitudinal study","volume":"23","author":"C Li","year":"2025","journal-title":"BMC Med"},{"key":"pone.0352857.ref033","doi-asserted-by":"crossref","first-page":"987526","DOI":"10.3389\/fpubh.2022.987526","article-title":"Association between social support and medication literacy in older adults with hypertension","volume":"10","author":"Z Shen","year":"2022","journal-title":"Front Public Health"},{"issue":"1","key":"pone.0352857.ref034","article-title":"Chronic disease management, self-efficacy and quality of life","volume":"29","author":"SW-C Chan","year":"2021","journal-title":"J Nurs Res"},{"key":"pone.0352857.ref035","doi-asserted-by":"crossref","first-page":"503","DOI":"10.2147\/PPA.S496707","article-title":"Exploring the perceptions and self-perceptions of therapeutic adherence in older adults with chronic conditions: a scoping review","volume":"19","author":"L Alc\u00e2ntara","year":"2025","journal-title":"Patient Prefer Adherence"},{"issue":"1","key":"pone.0352857.ref036","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s40885-021-00176-0","article-title":"Factors associated with medication adherence of hypertensive patients in the Philippines: a systematic review","volume":"27","author":"MM Gutierrez","year":"2021","journal-title":"Clin Hypertens"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0352857","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:26:59Z","timestamp":1784741219000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0352857"}},"subtitle":[],"editor":[{"given":"Fan","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":36,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0352857","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]}}}