Pharmaceutical literacy in Portuguese community pharmacies: A validation study

Pharmacy Practice

  • Pedro L Ferreira1Centre for Health Studies and Research of the University of Coimbra (CEISUC), PORTUGAL., 2Centre for Innovative Biomedicine and Biotechnology (CiBB), University of Coimbra, PORTUGAL.
  • Rui Cruz1Centre for Health Studies and Research of the University of Coimbra (CEISUC), PORTUGAL., 3Polytechnic Institute of Coimbra, Coimbra Health School, Department of Biomedical Laboratory Sciences, Dietetics and Nutrition, and Pharmacy, PORTUGAL., 4Laboratory for Applied Research in Health, Polytechnic Institute of Coimbra, PORTUGAL.
  • Diana Soares1Centre for Health Studies and Research of the University of Coimbra (CEISUC), PORTUGAL.
  • Inês Ribeiro1Centre for Health Studies and Research of the University of Coimbra (CEISUC), PORTUGAL., 2Centre for Innovative Biomedicine and Biotechnology (CiBB), University of Coimbra, PORTUGAL.

Volume 24 Issue 3 Pages 1-10

DOI: 10.18549/PharmPract.2026.3.3427

Abstract

Background: Health literacy is characterized by the ability to obtain, assess, and understand basic information that enables the proper use of medication. Medication-related literacy promotes therapeutic adherence, people’s quality of life and health gains. Objective: This study aimed at adapting and validating the Recognize and Address Limited Pharmaceutical Literacy (RALPH) for the Portuguese population. Methods: The steps recommended by the Report of the ISPOR Task Force for Translation and Cultural Adaptation were followed. After a pilot study conducted in a set of community pharmacies in the central region of Portugal, RALPH was administered to adult patients through digital platforms. Results: One-hundred-two patients were enrolled in the study, 68.6% women, with a mean age of 47.5 years. The pharmacotherapeutic groups with more incidence were the cardiovascular and the central nervous systems. The distribution of right answers in the three pharmaceutical literacy domains (72.2% functional, 84.3% communicative, 61.8% critical), revealed some difficulties in terms of basic reading and writing skills, as well as skills in understanding and applying information. In the determinants for literacy, age had statistically significant differences among groups in functional (p<0.05) and critical domains (p<0.001). In addition, participants with fewer years of education were associated to lower number of correct answers in communicative (p<0.001) and critical domains (p<0.001). Conclusions: The Portuguese version of the RALPH proved to be a valid instrument to be applied by professionals in community pharmacies to indicate patients’ pharmaceutical literacy, so professionals can adapt the provided care and counselling to the patient.

Keywords

  • Health literacy
  • Community pharmacy services
  • Patient medication knowledge
  • Patient health questionnaire
Pharmacy Practice

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