Medication literacy is a cornerstone of public health education, encompassing an individual’s ability to understand and apply information about medications to make informed decisions (King et al., 2011; Pouliot et al., 2018). Although the CDC, AHRQ, and HHS recognize health literacy as a national priority, patient experiences reveal ongoing gaps in understanding medications at discharge. This study examines patient-reported understanding of discharge medications across U.S. hospitals, focusing on national trends and regional variation in communication about medication purpose, use, and side effects.

This cross-sectional study analyzed national and state-level data from the HCAHPS survey, published by CMS in Quarter 1, 2024. The dataset includes responses from discharges occurring between April 1, 2023, and March 31, 2024, across 4,707 hospitals. Three HCAHPS items were analyzed regarding provider communication regarding the purpose, use, and side effects of medication. Descriptive statistics were used to assess national, state, and regional patterns. A one-way ANOVA was used to test regional differences across the four U.S. Census regions.

Results showed that 75% of patients reported that staff “always” explained what the medications were for, 62% reported receiving clear instructions for use, and 48% said that side effects were consistently discussed. South Dakota ranked highest across all three domains, with strong performance from Nebraska and Wyoming. New Jersey, Delaware, and the District of Columbia ranked lowest. Regionally, the Midwest had the highest average “always” responses. The ANOVA confirmed significant regional differences. Persistent gaps in medication understanding reinforce the need for improved provider communication and patient education strategies.