Factors Influencing Medication Literacy in Young and Middle-Aged Patients with NYHA Class I–III Heart Failure After Percutaneous Coronary Intervention: A Qualitative Study

Jiang-Ying Li,1,* Zhen-Qing Ren,1,* Xiao-Cui Wang,2 Wen-Juan Jiang,3 Li Ding,3 Cong Li,3 Pei-Yu Huang,3 Li-Chun Wang,1 Lu Chen11Department of Nursing, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, Jiangsu, 225300, People’s Republic of China; 2Cardiology Department, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, Jiangsu, 225300, People’s Republic of China; 3Department of Emergency, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou, Jiangsu, 225300, People’s Republic of China*These authors contributed equally to this workCorrespondence: Li-Chun Wang, Department of Nursing, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, No. 366 Taihu Road, Taizhou Pharmaceutical High-Tech District, Taizhou, Jiangsu, 225300, People’s Republic of China, Tel +86 18652711566, Email 18652711566@163.com Lu Chen, Department of Nursing, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, No. 366 Taihu Road, Taizhou Pharmaceutical High-Tech District, Taizhou, Jiangsu, 225300, People’s Republic of China, Tel +86 13641589385, Email 1346980341@qq.comObjective: To identify and understand the factors that influence medication literacy in young and middle-aged patients with NYHA class I–III heart failure following percutaneous coronary intervention (PCI).Methods: From October to December 2024, 21 post-PCI patients with NYHA class I–III heart failure aged 18– 65 were included in this study, using purposive sampling. Semi-structured interviews were conducted with them. Data were analyzed using directed content analysis for coding, categorization, and thematic extraction.Results: Four primary themes encapsulating the barriers to medication literacy emerged: (1) Deficiencies in foundational drug knowledge, stemming from overly simplistic patient education and a clinical focus on instructional process over practical understanding; (2) Insufficient communication channels with healthcare providers and within families; (3) A lack of critical appraisal skills, evident in persistent cognitive biases and an overreliance on unvetted online health information; and (4) Poor medication management literacy, driven by challenges in adapting lifestyles, work and travel schedules, role transitions, and coping with treatment-related negative emotions.Conclusion: Enhancing medication literacy in this patient population requires a multifaceted strategy. Healthcare teams should develop more nuanced, interactive education programs, establish robust communication and social support systems, actively address patients’ cognitive biases while improving their e-health literacy, and help patients integrate medication management seamlessly into their daily routines.Keywords: young and middle-aged adults, percutaneous coronary intervention, NYHA class I–III heart failure, medication literacy, influencing factors, qualitative research