Prescription Understanding and Associated Factors Among Patients Attending a Rural Community Health Centre in Uttar Pradesh, India: A Cross-Sectional Study

Abstract

Background: Inadequate prescription understanding is a major public health concern that contributes to medication non-adherence, treatment failure, and adverse drug events, particularly in rural populations. Evidence on prescription comprehension among patients attending rural healthcare facilities in India remains limited. This study assessed prescription understanding and its associated factors among patients attending a rural Community Health Centre (CHC) in Uttar Pradesh.
Methods: A facility-based cross-sectional study was conducted among 330 adult outpatients attending a rural CHC from January to March 2026. Participants were selected using systematic random sampling. Prescription understanding was assessed through structured exit interviews covering six components: drug name, dose, frequency, duration, timing with food, and special instructions. Understanding scores were categorized as good (≥75%), moderate (50–74%), or poor (<50%). Factors associated with poor prescription understanding were assessed using multivariable logistic regression and reported as adjusted odds ratios (AORs) with 95% confidence intervals (CIs).
Results: The majority of participants were aged 30–44 years (32.7%), male (53.3%), and rural residents (78.2%). Overall, only 23.0% of participants demonstrated good prescription understanding, while 46.1 and 30.9% had moderate and poor understanding, respectively. Domain-specific comprehension was highest for treatment duration (60.9%) and lowest for special instructions (38.2%). In the multivariable analysis, illiteracy (AOR = 5.2; 95% CI: 2.1–12.8), absence of prescription counselling (AOR = 3.4; 95% CI: 2.0–5.8), polypharmacy ( medicines) (AOR = 2.6; 95% CI: 1.5–4.4), age years (AOR = 2.3; 95% CI: 1.2–4.5), and rural residence (AOR = 1.7; 95% CI: 1.0–3.0) were independently associated with poor prescription understanding.
Conclusion: Prescription understanding among patients attending the rural CHC was suboptimal. Illiteracy, older age, polypharmacy, rural residence, and a lack of structured prescription counselling were significant independent predictors of poor comprehension. Strengthening point-of-care patient counselling and adopting literacy-sensitive communication strategies are crucial to improving medication safety in rural settings.