Health Literacy Impairment and Awareness of Clinical Pharmacist Services Among Geriatric Tertiary-Care Outpatients: A Cross-Sectional Study

Background: Health literacy plays an important role in medication understanding, self-management, and engagement with healthcare services among older adults. Limited health literacy may contribute to medication-related problems and reduced utilization of pharmacist-led services in geriatric populations. Methods: A cross-sectional, questionnaire-based survey was conducted among geriatric outpatients (≥60 years) attending a tertiary-care teaching hospital in Saudi Arabia. Health literacy was assessed using a four-domain functional tool—covering prescription label comprehension, understanding of healthcare instructions, confidence in completing medical forms, and comprehension of written health information—developed in alignment with established health literacy frameworks, including the Health Literacy Survey—European Union (HLS-EU) model and Baker’s conceptual framework. Participants were classified as having higher health literacy (0–2 domains impaired) or lower health literacy (3–4 domains impaired). Sociodemographic characteristics, clinical burden, medication self-management behaviors, and awareness of clinical pharmacist services were recorded. Multivariable logistic regression was used to identify factors independently associated with lower health literacy. Results: A total of 200 participants were included. Impairment in three or more domains was observed in 55.5% of participants. Lower health literacy was independently associated with older age, lower educational attainment, lower income, female sex, multimorbidity, and polypharmacy. Participants with lower health literacy reported higher rates of missed or incorrect medication dosing and unreported adverse drug reactions and lower use of medication management aids. Awareness of clinical pharmacist services and prior exposure to pharmacist counseling were significantly lower among participants with lower health literacy. Willingness to receive pharmacist counseling was higher among participants with higher health literacy and greater awareness of pharmacist roles. Conclusions: Health-literacy impairment is common among geriatric outpatients and is associated with medication self-management behaviors and engagement with pharmacist-led services. These findings highlight the relevance of functional health literacy in geriatric medication use and support further research on literacy-sensitive pharmacist-led interventions.