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

In chronic disease management, perceived effectiveness of patient-physician interaction may be associated with health literacy, patient adherence, and clinical processes. This study was conducted to examine the relationships of health literacy and patient adherence with the perceived effectiveness of patient-physician interactions among individuals with chronic diseases registered with family physicians. This cross-sectional study was conducted in 12 Family Health Centers in Türkiye between June 23 and July 13, 2026. 422 adult patients with at least one chronic disease were included using stratified and convenience sampling. Data were collected using a sociodemographic/clinical form, the European Health Literacy Scale Short Form, the Patient Compliance Scale, and the Perceived Effectiveness of Patient-Physician Interactions Scale. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis, and two-step Multiple Linear Regression were used in the analyses. The median age of the participants was 48.0, and 55.5% were female. The most common chronic diseases in the study group were hypertension (54.0%), diabetes (38.2%), and COPD/Asthma (34.4%). 14.7% of the participants had insufficient health literacy, 64.9% had problematic health literacy, and 20.4% had sufficient health literacy. The median scale scores were 16.00 for health literacy, 20.00 for patient compliance, and 40.50 for perceived effectiveness of patient-physician interaction. In the regression model adjusted for demographic and clinical variables (R²=0.410; p < 0.001), both health literacy (β = 0.196; p < 0.001) and patient adherence (β = 0.448; p < 0.001) were positively associated with the perceived effectiveness of patient-physician interaction. A disease duration of more than 10 years was positively associated with PEPPI scores (β = 0.183; p = 0.008), whereas reporting that internet-based information influenced treatment decisions was negatively associated with PEPPI scores (β=−0.104; p = 0.016). Higher levels of health literacy and patient adherence were associated with higher perceived effectiveness of patient-physician interaction among individuals with chronic diseases. It is recommended that primary care physicians focus on interventions that strengthen patient communication and increase patients’ health literacy and treatment adherence.