AUTHOR=Levic Marija , Bogavac-Stanojevic Natasa , Krajnovic Dusanka 

TITLE=The Instruments Used to Assess Health Literacy and Pharmacotherapy Literacy of Diabetes Mellitus Type 2 Patients: A Scoping Review

JOURNAL=Frontiers in Public Health

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.747807

DOI=10.3389/fpubh.2021.747807

ISSN=2296-2565

ABSTRACT=Background: Patients with chronic diseases, like diabetes need to continuously perform tasks associated with self-management especially with medications they use. It is shown that the patients with diabetes with limited HL and PTHL cannot read medication labels correctly, may misuse their medications, spend much more on therapy and generally have difficulties in understanding printed care instructions and perceiving health advice and warnings. There has been an increasing demand for valid and reliable instruments for HL and PTHL assessment in this population. This review aims to search and critically discuss instruments used to assess HL and PTHL in people with type 2 diabetes and to propose their use in different settings.

Methods: Scopus and PubMed were searched, during November and the first two weeks of December 2020 to find relevant papers. The review was conducted in accordance with the Cochrane guidelines and the reporting was based on the PRISMA-ScR. The comparison of instruments was made by utilising a comparison model related to their structure, measurement scope, scoring, psychometric properties, validation, strengths, and limitations.

Results: The final number of included studies was 24, extracting the following identified instruments: Korean Functional Test HL, NVS, FCCHL, HLS-EU-47, TOFLHA, S-TOFHLA, REALM-R, 3-brief SQ, REALM, HLQ and DNT-15. 
In all, FCCHL and 3-brief SQ are shown with the broadest measurement scopes and can be considered the best for measuring functional HL in patients with diabetes mellitus type 2 and other chronic diseases. They are quick, easy, and inexpensive for administration. FCCHL can be considered the most useful and comprehensive instrument to screen for inadequate HL. The limitation is that the English version is not validated. 3-brief SQ has many advantages in comparison to other instruments, including that it is less likely to cause anxiety and shame. The PTHL instruments (REALM and DNT-15) did not find the best application in this population.

Conclusions: The future research should be directed in validation in English and establishing of the structural validity of the FCCHL. Developing a specific PTHL questionnaire for this population will be of great help in management of their disease.