Health Literacy and Treatment Adherence in Older Patients with Hypertension

Abstract

I read with great interest the recent article by Taskin Yilmaz et al (Vol. 20, No. 2, 2025) examining the association between health literacy and treatment adherence among older patients with hypertension.
The authors’ findings-particularly the significant relationship between both functional and communicative health literacy scores and improved blood pressure control-provide valuable evidence for refining patient-centered educational strategies.
I wish to highlight two practical points and offer one suggestion for future research. First, the authors reported that media exposure and active search for health information were linked to better blood pressure control. This observation suggests that community-based educational modules—such as short instructional videos tailored for older adults and family-centered counseling sessions-could be implemented and evaluated as adjuncts to routine care. Second, given the cross-sectional design of the study, causal inference remains limited. Potential confounders such as cognitive status and social support may also influence both literacy and adherence. Incorporating brief cognitive screening tools (eg, Mini-Cog) and validated social support scales in future studies would help clarify whether health literacy acts as an independent mediating factor.
Finally, I recommend evaluating a structured low-literacy educational package delivered during hospitalization and reinforced through nurse-led telephone follow-up. This model is practical, scalable, and allows measurable outcomes in blood pressure control within 3 months, potentially improving quality of life while reducing the burden on health care systems.