Background: Despite the impact of medication literacy (ML) on patients’ safe use of medications, existing instruments are mostly for general health literacy measurement or designed for specific disease populations, with few specifically designed for ML.Objective: To develop and validate the first Chinese medication literacy measure (ChMLM).Methods: The ChMLM was developed by a multidisciplinary and bilingual expert panel and subsequently pilot‐tested. The final version had 17 questions in four sections: vocabulary, non‐prescription drug, prescription drug and drug advertisement. Face‐to‐face interviews were administered in a convenience sample of adults with diverse sociodemographic characteristics. Internal consistency was assessed by Cronbach's alpha. Content validity was confirmed by the expert panel, and hypothesis testing was performed to assess construct validity.Results: A total of 634 adults were interviewed. The mean (SD) total ChMLM score was 13.0 (2.8). The internal validity was acceptable (Cronbach's alpha=0.72). Nine of the ten a priori hypotheses were fulfilled. Younger age, higher income and higher education levels were significantly associated with a higher ChMLM score. Furthermore, higher scores on the ChMLM were associated with higher confidence or less difficulty in writing, reading, speaking and listening abilities in a health‐care encounter. No association was found between ChMLM total scores and frequency of doctor's visits.Conclusion: The ChMLM is a valid and reliable ML measure. It may help pharmacists and other health‐care providers to target patients and problem areas that need interventions with the ultimate goal of preventing medication errors and harm.

To estimate the healthcare utilization and costs of major diabetes mellitus (DM)-related complications in Taiwan in the year of first occurrence and in subsequent years. This study is a retrospective claim database analysis using the longitudinal cohort of diabetes patients (LHDB) with 2012 as the base year. Occurrences of 8 DM-related complications of interest were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Annual healthcare costs and utilization of these DM-related complications in the LHDB cohorts of the years 2004 to 2009 were examined, and the generalized linear model was used to estimate annual total healthcare costs for each complication. DM patients with complications were more likely to have at least 1 emergency room (ER) visit and at least 1 hospitalization (both P < .001), and they also had more outpatient visits, higher hospitalization costs, higher outpatient costs, and higher ER costs (all P < .001) than those without. The mean annual total healthcare cost of the patients with DM-related complications was US $4189, whereas the mean annual cost of those patients without complication was $1424 (P < .001). The complications with the greatest event costs were amputation ($7877; 95% confidence interval [CI]: $6628–$9322) and fatal MI ($4067; 95% CI: $3001–$5396) while the complication with the greatest state costs was end-stage renal disease (ESRD) ($2228; 95% CI: $2155 to $2302). DM-related complications could significantly increase healthcare utilization and costs. The results of this study provide data that are useful for local economic evaluations of DM treatments.

Background. Diabetes mellitus (DM) has become a significant worldwide public health problem and economic burden because a great proportion of healthcare costs has been spent on the treatment of DM and its related complications. The aim of this study was to examine the costs and length of stay (LoS) of hospitalizations due to diabetes-related complications in Taiwan. Methods. This study is a retrospective claim database analysis using the Longitudinal Cohort of Diabetes Patients, with 2012 used as the base year. The hospitalization costs and LoS per admission were estimated for each complication of interest using data from the LHDB 2004 to 2012 cohorts. The presence of eight DM-related complications were identified using the ICD-9-CM codes and procedure codes. ANOVA was used to examine the relationships of diabetes duration with the LoS and costs of the complications. Results. A total of 27,473 DM patients who were hospitalized in 2012 due to one of the examined DM-related complications were identified. The most common complications that caused the hospitalizations were nonfatal stroke (34.7%) and nonfatal ischemic heart disease (IHD) (28.7%). Amputation was the complication with the longest hospital stay, with a mean±SD of 21.6±14.1days, followed by nonfatal stroke (13.6±11.3), ulcer (12.7±11.8), and fatal IHD (12.2±13.6). The complications with the greatest hospitalization cost were fatal IHD (mean=TWD306,209.8; median=TWD221,417.0; 1TWD=0.034USD) and fatal myocardial infarction (mean=TWD272,840.1; median=TWD174,008). Conclusions. This study indicates that DM-related complications are associated with significant hospital LoS and costs. The study results could be useful for economic evaluations of diabetes treatments and the estimation of the overall economic impact of diabetes.