{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:22:52Z","timestamp":1791829372323,"version":"4.3.4"},"reference-count":34,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,13]],"date-time":"2019-09-13T00:00:00Z","timestamp":1568332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004564","name":"Ministarstvo Prosvete, Nauke i Tehnolo\u0161kog Razvoja","doi-asserted-by":"publisher","award":["Grant Number 41004"],"award-info":[{"award-number":["Grant Number 41004"]}],"id":[{"id":"10.13039\/501100004564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Pharmacotherapy literacy (PHTL) is an individual\u2019s capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy-related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g., written, oral, visual images and symbols). It is already proven that low PHTL of parents can cause serious problems in the treatment of a pediatric population. We aimed to identify the differences in parental PHTL levels, socio-demographic and health-related characteristics (chronic disease of a child, breastfeeding of a child, annual visits to a pediatrician, parental-self-estimation of health status) between rural and urban areas and to investigate the influence of living in rural areas on a low PHTL level. Materials and methods: Our study was cross-sectional with a validated 14-item instrument (\u201cParental pharmacotherapy literacy questionnaire\u2014Serbian\u201d), which assessed overall PHTL and its three domains of knowledge, understanding and numerical skills necessary for the safe use of medicines. We analyzed 250 parents of pre-school children (1\u20137 years old) in rural areas and 182 parents from urban areas in Serbia. Results: Every tenth parent from rural and every fourth parent from urban areas had the highest PHTL level or more than 85% correct answers. However, 51% and 28% of parents in rural and urban areas, respectively, had a low PHTL level (less than 65% correct answers), [\u04252(1, n = 432) = 33.2; p &lt; 0.001]. Parents from different areas statistically differed in age, education level, employment, breastfeeding and annual visits to pediatrician rate. Those from rural areas had almost twice the probability of low PHTL levels (ORa = 2.033; p = 0.003) than their urban counterparts, independently of other examined parental characteristics. Conclusions: Parents from rural areas have more difficulties to obtain, evaluate, calculate and comprehend basic information related to pharmacotherapy than parents from urban areas.<\/jats:p>","DOI":"10.3390\/medicina55090590","type":"journal-article","created":{"date-parts":[[2019,9,16]],"date-time":"2019-09-16T03:17:57Z","timestamp":1568603877000},"page":"590","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Pharmacotherapy Literacy of Parents in the Rural and Urban Areas of Serbia\u2014Are There Any Differences?"],"prefix":"10.3390","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1699-7944","authenticated-orcid":false,"given":"Du\u0161anka","family":"Krajnovi\u0107","sequence":"first","affiliation":[{"name":"Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, 11221 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stana","family":"Ubavi\u0107","sequence":"additional","affiliation":[{"name":"Medicines and Medical Devices Agency of Serbia (ALIMS), 11221 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nata\u0161a","family":"Bogavac-Stanojevi\u0107","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11221 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1080\/10810730.2014.936571","article-title":"Health literacy measurement: An inventory and descriptive summary of 51 instruments","volume":"19","author":"Haun","year":"2014","journal-title":"J. Health Commun."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1093\/heapro\/15.4.277","article-title":"Health literacy: A challenge for American patients and their health care providers","volume":"15","author":"Parker","year":"2000","journal-title":"Health Promot. Int."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"World Health Organization (2017). Shanghai declaration on promoting health in the 2030 Agenda for Sustainable Development. Health Promot. Int., 32, 7.","DOI":"10.1093\/heapro\/daw103"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1093\/eurpub\/ckv043","article-title":"Health literacy in Europe: Comparative results of the European health literacy survey (HLS-EU)","volume":"25","author":"Pelikan","year":"2015","journal-title":"Eur. J. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1080\/13814788.2019.1571579","article-title":"Assessment of health literacy in the adult population registered to family medicine physicians in the Republic of Srpska, Bosnia and Herzegovina","volume":"25","author":"Todorovic","year":"2019","journal-title":"Eur. J. Gen. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1542\/peds.2009-1162E","article-title":"The health literacy of parents in the United States: A nationally representative study","volume":"124","author":"Yin","year":"2009","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.sapharm.2012.05.009","article-title":"Assessing readability formula differences with written health information materials: Application, results, and recommendations","volume":"9","author":"Wang","year":"2013","journal-title":"Res. Soc. Adm. Pharm."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Krajnovi\u0107, D., Ubavi\u0107, S., and Bogavac-Stanojevi\u0107, N. (2019). Pharmacotherapy literacy and parental practice in use of over-the-counter pediatric medicines. Medicina, 55.","DOI":"10.3390\/medicina55030080"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1211\/ijpp.17.05.0001","article-title":"Addressing medication literacy: A pharmacy practice priority","volume":"17","author":"Raynor","year":"2009","journal-title":"Int. J. Pharm. Pract."},{"key":"ref_10","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":"Pouliot","year":"2018","journal-title":"Res. Soc. Adm. Pharm."},{"key":"ref_11","first-page":"335","article-title":"Medication Literacy: Why Pharmacists Should Pay Attention","volume":"69","author":"Pouliot","year":"2016","journal-title":"Can. J. Hosp. Pharm."},{"key":"ref_12","first-page":"213","article-title":"Health literacy in the pharmacy setting: Defining pharmacotherapy literacy","volume":"9","author":"King","year":"2011","journal-title":"Pharm. Pract."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ubavi\u0107, S., Bogavac-Stanojevi\u0107, N., Jovi\u0107-Vrane\u0161, A., and Krajnovi\u0107, D. (2018). Understanding of information about medicines use among parents of pre-school children in Serbia: Parental pharmacotherapy literacy questionnaire (PTHL-SR). Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15050977"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S265","DOI":"10.1542\/peds.2009-1162B","article-title":"Health literacy and child health outcomes: A systematic review of the literature","volume":"124","author":"Dewalt","year":"2009","journal-title":"Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"550","DOI":"10.5993\/AJHB.33.5.8","article-title":"Health literacy skills in rural and urban populations","volume":"33","author":"Zahnd","year":"2009","journal-title":"Am. J. Health Behav."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1016\/j.socscimed.2005.08.045","article-title":"A comparison of health inequalities in urban and rural Scotland","volume":"62","author":"Levin","year":"2006","journal-title":"Soc. Sci. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1177\/0022034515575538","article-title":"Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region","volume":"27","author":"Ogunbodede","year":"2015","journal-title":"Adv. Dent. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1093\/heapro\/dax015","article-title":"Improving health literacy in community populations: A review of progress","volume":"33","author":"Nutbeam","year":"2017","journal-title":"Health Promot. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.5993\/AJHB.31.s1.4","article-title":"The causal pathways linking health literacy to health outcomes","volume":"31","author":"Wolf","year":"2007","journal-title":"Am. J. Health Behav."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/j.1442-2018.2008.00394.x","article-title":"Health literacy: A concept\/dimensional analysis","volume":"10","author":"Mancuso","year":"2008","journal-title":"Nur. Health Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1023\/A:1019558817136","article-title":"Why do the children of the poor die in Dhaka, Bangladesh?","volume":"21","author":"Caldwell","year":"2002","journal-title":"Popul. Res. Policy Rev."},{"key":"ref_22","first-page":"7567","article-title":"A study on the health literacy of the elderly in rural area","volume":"28","author":"Lee","year":"2017","journal-title":"Biomed. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.puhe.2015.01.005","article-title":"Access to medicines in remote and rural areas: A survey of residents in the Scottish Highlands & Western Isles","volume":"129","author":"Rushworth","year":"2015","journal-title":"Public Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/1757975913502686","article-title":"Assessing health literacy in rural settings: A pilot study in rural areas of Cluj County, Romania","volume":"20","author":"Pop","year":"2013","journal-title":"Glob. Health Promot."},{"key":"ref_25","first-page":"1151","article-title":"Source of medicines and medicine information by self-reported persons living with hypertension and diabetes in rural and Urban Ghana","volume":"16","author":"Buabeng","year":"2018","journal-title":"Pharm. Pract."},{"key":"ref_26","first-page":"e201807042","article-title":"Dise\u00f1o, construcci\u00f3n y evaluaci\u00f3n de una escala para medir la actitud hacia la automedicaci\u00f3n en adolescentes","volume":"92","author":"Ortega","year":"2018","journal-title":"Rev. Espa\u00f1ola De Salud P\u00fablica"},{"key":"ref_27","unstructured":"Gavrilovic, D. (2018). Statistical Yearbook of The Republic of Serbia."},{"key":"ref_28","unstructured":"World Data Bank, United Nations Population Division (2019, July 28). World Urbanization Prospects: 2018 Revision. Available online: https:\/\/data.worldbank.org\/indicator\/SP.URB.TOTL.IN.ZS?name_desc=false."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ubavic, S., and Krajnovic, D. (2018). Pharmacotherapy literacy (PTHL-SR) questionnaire for parents of pre-school children in Serbia: Construction and psychometric characteristics. Vojnosanit Pregl., in press.","DOI":"10.2298\/VSP170721002U"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/ajr.12362","article-title":"Breastfeeding beyond the big smoke: Who provides support for mothers in rural Western Australia?","volume":"25","author":"Cox","year":"2017","journal-title":"Aust. J. Rural. Health"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Adewuyi, E.O., Auta, A., Khanal, V., Bamidele, O.D., Akuoko, C.P., Adefemi, K., Tapshak, S.J., and Zhao, Y. (2018). Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197324"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.3390\/ijerph10031125","article-title":"Health literacy in rural areas of China: Hypertension knowledge survey","volume":"10","author":"Li","year":"2013","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S156","DOI":"10.1016\/j.jpeds.2016.04.053","article-title":"The Child Health Care System of Serbia","volume":"177S","author":"Bogdanovic","year":"2016","journal-title":"J. Pediatrics"},{"key":"ref_34","unstructured":"Ministry of Health of the Republic of Serbia (2019, June 17). Results of the National Health Survey of the Republic of Serbia 2013, Available online: http:\/\/www.batut.org.rs\/download\/publikacije\/2013SerbiaHealthSurvey.pdf."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/9\/590\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:20:01Z","timestamp":1760188801000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/9\/590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,13]]},"references-count":34,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9]]}},"alternative-id":["medicina55090590"],"URL":"https:\/\/doi.org\/10.3390\/medicina55090590","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,13]]}}}