Assessment of the association between asthma-related numeracy and medication adherence among asthma patients in Jordan

Background: Medication adherence is a vital element in the management of chronic diseases such as asthma, yet nonadherence remains a persistent challenge, particularly in regions with suboptimal health literacy (HL) levels. In the Middle East, where asthma prevalence is substantial, the association between asthma-related numeracy and adherence behaviors has not been sufficiently studied. This study aimed to assess the association between asthma-related numeracy, as one aspect of health literacy, and adherence to prescribed treatments among adult asthmatic patients. Methods: A cross-sectional survey was administered to 400 adults with physician-diagnosed asthma attending a pulmonary clinic at a major Jordanian hospital. Asthma-related numeracy was measured using the Arabic Asthma Numeracy Questionnaire (Ar-ANQ), while adherence was assessed with the MARS-5 scale, with total scores ≥24 classified as high adherence. Asthma control was assessed using four symptom-control items. Logistic regression models estimated the odds of high adherence after adjustment for sociodemographic, medication, clinical, and numeracy-related variables. Results: A total of 45.3% of the patients were classified as having high adherence. Higher Ar-ANQ scores were significantly associated with higher odds of high adherence (OR = 2.924, 95% CI: 2.249–3.801, p < 0.001). Low income (OR = 0.289, p = 0.001) and older age (OR = 0.966, p = 0.021) were significantly associated with lower odds of high adherence, while lower educational attainment showed a borderline association (OR = 0.518, p = 0.067). Conclusion: Inadequate asthma-related numeracy was associated with lower adherence in Jordanian adults. Addressing disparities tied to age and income, while using numeracy-sensitive communication, may support medication adherence and asthma management.