Digital Literacy, Social Support, and Aging Attitudes Linked to Medication Adherence

Better eHealth literacy, positive attitudes toward aging, and stronger social support are independently associated with higher medication adherence among community-dwelling older adults managing polypharmacy, according to a cross-sectional study. Within the surveyed sample, overall medication adherence was found to be moderate-to-good. The investigation evaluated these relationships within the framework of the Capability-Opportunity-Motivation-Behavior model, addressing the challenge that polypharmacy presents for medication adherence among older adults residing in community settings.

The study was designed to investigate the current status of medication adherence among community-dwelling older adults who manage polypharmacy. In addition to examining baseline adherence, the research aimed to explore how digital health literacy and social support relate to adherence levels, and to determine whether attitudes toward aging serve a statistically mediating role in those associations within the structured behavioral framework.

The research was conducted as a cross-sectional study from May to November 2025 across three community health service centers in China. The study participants included 552 older adults aged 60 years or older. All included participants met the criterion of taking five or more daily medications, reflecting the presence of polypharmacy in this community-dwelling demographic.

To assess the relevant behavioral, cognitive, and interpersonal dimensions, the researchers collected data using four validated measurement instruments: the Medication Adherence Rating Scale, the eHealth Literacy Scale, the Attitudes to Aging Questionnaire, and the Social Support Rating Scale. All statistical analyses were performed using SPSS version 27.0. The analytical procedures included descriptive statistics to summarize participant characteristics, univariate analyses and multivariate analyses to assess independent associations with adherence, and mediation analysis to evaluate potential mediating pathways.

Multivariate analyses confirmed that higher eHealth literacy, more positive attitudes toward aging, and stronger social support were each independently associated with higher medication adherence among the participants. Furthermore, mediation models showed that attitudes toward aging partially explained the associations of both eHealth literacy and social support with medication adherence. In the model assessing digital literacy, the indirect effect of eHealth literacy through attitudes toward aging was 0.054, with a 95 percent confidence interval spanning from 0.036 to 0.073, which accounted for 30.2 percent of the total effect. In the model assessing interpersonal support, the indirect effect of social support through attitudes toward aging was 0.093, with a 95 percent confidence interval spanning from 0.069 to 0.123, which accounted for 47.9 percent of the total effect.

The authors concluded that better digital health skills and stronger social support are positively associated with medication adherence, and that positive views on aging are linked to more favorable adherence outcomes among older adults with polypharmacy. For future application, the researchers noted that community health interventions for this population could consider incorporating psychological factors and patient-centered communication models. However, the authors explicitly stated that the effectiveness of such intervention approaches requires further validation.

Subject of Research: Determinants of medication adherence among older adults with polypharmacy

Article Title: Determinants of medication adherence in community-dwelling older adults with polypharmacy: a cross-sectional study based on the COM-B model

Article References: Teng, Y., & Wu, Y. (2026). Determinants of medication adherence in community-dwelling older adults with polypharmacy: a cross-sectional study based on the COM-B model. BMC Geriatrics. https://doi.org/10.1186/s12877-026-08647-5

Image Credits: AI Generated

DOI: 10.1186/s12877-026-08647-5

Keywords: medication adherence, polypharmacy, older adults, eHealth literacy, social support, attitudes toward aging, COM-B model, cross-sectional study, Determinants, medication, adherence, community-dwelling