The impact of socio-demographic determinants on rational drug use literacy among aging populations: A meta-analysis and systematic review.

BACKGROUND

Population aging in Asia heightens the demand for effective medication management, with rational drug use literacy (RDUL) being crucial for safe and appropriate medication use. However, evidence on socio-demographic determinants of RDUL remains limited.

OBJECTIVE

To examine socio-demographic factors associated with RDUL among aging populations.

METHODS

A systematic review and meta-analysis of observational studies was conducted through comprehensive searches of seven electronic databases, supplemented by grey literature and organizational library sources, covering publications up to May 2026. Eligible studies were selected based on inclusion criteria, and methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled associations between socio-demographic factors and RDUL were estimated using random-effects models with restricted maximum likelihood (REML) and Hartung-Knapp-Sidik-Jonkman (HKSJ)confidence intervals. REML with Wald-type (WT) confidence intervals and fixed-effect models were used for sensitivity analyses. The protocol was registered in PROSPERO (CRD42025635989).

RESULTS

Of the 21,702 records screened, nine studies were eligible. Seven were identified through database searches and two through hand searching. All were assessed as moderate to high quality. Education level was the only socio-demographic factor significantly associated with RDUL, whereby individuals with a higher education were 2.61 times more likely to achieve adequate RDUL compared with those with a lower education (95% CI: 1.75-3.89; p <0.001; I2 = 88.7%). Collective socio-demographic factors (age, sex, education, employment, marital, and living status) were significantly associated with RDUL (OR = 1.41; 95% CI: 1.19-1.68; p < 0.001; I2 = 94.6%). Of these, only education was significantly associated with RDUL, whereas the remaining factors showed no significant or robust associations.

CONCLUSION

Education level was a key determinant of RDUL, with significance observed only for collective socio-demographic factors. However, evidence remains limited due to low robustness, few studies, and a lack of specific assessment tools.