Association between Health Literacy and Medication Adherence among Pulmonary Tuberculosis Patients Using Four Domains of the Integrated Health Literacy Model in Jember Regency, Indonesia

Health literacy is one of the factors that can influence tuberculosis medication adherence. Due to inadequate health literacy, patients had not fully used the information received related to tuberculosis in their daily behavior to support recovery. This research analyzes the association between domains of health literacy and medication adherence among pulmonary tuberculosis patients. This retrospective study analyzed the association between health literacy and medication adherence of 150 pulmonary tuberculosis patients in four primary healthcare units in Jember Regency. The participants were composed of; 1) adhere (had no history of interrupt medication > 1 month in 2021) and already recovered and 2) non-adhere (had a history of not taking medication for > 1 month in 2021). The prepared research assistants and health volunteers carried out the data collection. Descriptive statistics and the chi-square test were applied to analyze the data. Collection data held from October-November 2022. This study found that 128 participants adhered to and 22 did not adhere to tuberculosis medication. Forty-two percent of the participants (63 of 150) had a sufficient health literacy level. There was a significant association between health literacy level and medication adherence (p<.001).  All health literacy domains significantly associated with medication adherence with access (p=0.001), understand (p<0.001), appraise (p<0.001), and apply (p<0.001). Most participants had sufficient health literacy and good skills in accessing, understanding, appraising, and applying tuberculosis-related information. Health workers can improve tuberculosis patients’ ability to appraise and apply tuberculosis health information by providing continuous health counseling.