Association between health empowerment and medication literacy among older adults with coronary heart disease after PCI: the mediating role of self-efficacy for appropriate medication use

BackgroundWith the acceleration of global population ageing and the increasing burden of chronic diseases, the number of older adults with coronary heart disease is steadily increasing. Medication literacy is an important foundation for safe medication use and is closely associated with medication management and secondary prevention among older adults with CHD after percutaneous coronary intervention. However, research on medication literacy in this population remains relatively limited, and factors associated with medication literacy have not been sufficiently investigated. Therefore, further research is needed to examine the factors associated with medication literacy among older adults with CHD after PCI, which may help inform future targeted intervention studies and the development of appropriate clinical interventions.ObjectiveTo investigate the status of medication literacy among older adults with coronary heart disease after PCI, examine the association between health empowerment and medication literacy, and further assess the indirect association of self-efficacy for appropriate medication use in this relationship.MethodsThis study adopted a cross-sectional survey design. Using convenience sampling, 483 older adults with coronary heart disease after PCI were recruited from two Grade A tertiary hospitals in Sichuan Province, China, from March to October 2025. On-site questionnaire surveys were conducted. The research instruments included the demographic characteristics, patient perceptions of empowerment scale, self-efficacy for appropriate medication use scale, and medication literacy scale for patients after PCI. Statistical analyses were performed using SPSS 26.0 and its PROCESS macro program.ResultsAmong the 483 older adults with coronary heart disease after PCI in this study, the score of health empowerment was 36.69 ± 6.19, the score of self-efficacy for appropriate medication use was 28.25 ± 4.73, and the score of medication literacy was 70.62 ± 17.82. Pearson correlation analysis showed that medication literacy was positively correlated with health empowerment (r = 0.810, p < 0.01) and self-efficacy for appropriate medication use (r = 0.821, p < 0.01), while health empowerment was positively correlated with self-efficacy for appropriate medication use (r = 0.811, p < 0.01). Mediation analysis showed a statistically significant indirect association between health empowerment and medication literacy through self-efficacy for appropriate medication use, with an indirect effect of 0.346. This indirect effect accounted for 47.92% of the total effect (95% CI: [0.287, 0.410]). In addition, the total effect was 0.722 (95% CI: [0.666, 0.777]), and the direct effect was 0.376 (95% CI: [0.299, 0.452]).ConclusionMedication literacy among older adults with coronary heart disease after PCI was at a moderate level. Health empowerment, self-efficacy for appropriate medication use, and medication literacy were significantly and positively associated with one another, and a statistically significant indirect association between health empowerment and medication literacy through self-efficacy for appropriate medication use was observed. These findings suggest that healthcare professionals should consider health empowerment and self-efficacy for appropriate medication use when developing strategies to improve medication literacy among older adults after PCI, which may provide a reference for future intervention studies.