Health Literacy and Adherence Linked to Perceived Doctor Interaction Effectiveness

Higher levels of health literacy and patient adherence are positively associated with how effectively individuals with chronic diseases perceive their interactions with physicians, according to a cross-sectional study conducted across primary care centers in Türkiye. In an adjusted multiple linear regression analysis, both health literacy and patient adherence demonstrated statistically significant positive relationships with perceived patient-physician interaction effectiveness among adult patients registered with family physicians.

The investigation was carried out across 12 Family Health Centers between June 23 and July 13, 2026. Researchers enrolled 422 adult patients who had been diagnosed with at least one chronic medical condition, employing a combination of stratified and convenience sampling methods to recruit the study cohort.

To evaluate participants, data were gathered through a sociodemographic and clinical form alongside three standardized assessment instruments: the European Health Literacy Scale Short Form, the Patient Compliance Scale, and the Perceived Effectiveness of Patient-Physician Interactions Scale. Analytical procedures included descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, and a two-step multiple linear regression model.

Within the sample, the median age was 48.0 years, and 55.5% of the participants were female. The most prevalent chronic conditions reported were hypertension at 54.0%, diabetes at 38.2%, and COPD or asthma at 34.4%. Assessments of health literacy revealed that 14.7% of participants had insufficient literacy, 64.9% exhibited problematic literacy, and 20.4% possessed sufficient health literacy. Across the evaluation scales, median scores were 16.00 for health literacy, 20.00 for patient compliance, and 40.50 for perceived effectiveness of patient-physician interaction.

In the two-step multiple linear regression model adjusted for demographic and clinical variables, which accounted for substantial variance (R² = 0.410; p < 0.001), health literacy (β = 0.196; p < 0.001) and patient adherence (β = 0.448; p < 0.001) remained positively associated with perceived interaction effectiveness. Having a disease duration greater than 10 years was also positively associated with scores on the Perceived Effectiveness of Patient-Physician Interactions Scale (β = 0.183; p = 0.008). Conversely, patients who reported that internet-based information influenced their treatment decisions showed a negative association with interaction scores (β = −0.104; p = 0.016). Based on these findings, the authors recommended that primary care physicians focus on interventions designed to strengthen patient communication while supporting health literacy and treatment adherence.

Subject of Research: Health literacy, patient adherence, and patient-physician interactions in chronic disease management

Article Title: Associations of health literacy and patient adherence with perceived effectiveness of patient–physician interaction among patients with chronic diseases in primary care

Article References: Yılmazel, G., Doğan, İ., Demirhan Keleş, H., & Keleş, E. (2026). Associations of health literacy and patient adherence with perceived effectiveness of patient–physician interaction among patients with chronic diseases in primary care. BMC Primary Care. https://doi.org/10.1186/s12875-026-03642-6

Image Credits: AI Generated

DOI: 10.1186/s12875-026-03642-6

Keywords: health literacy, patient adherence, patient-physician interaction, primary care, chronic disease, family medicine, treatment compliance, cross-sectional study, Associations, health, literacy, patient