Communication Difficulties and Associations With Health Literacy, Medication Beliefs, and Adherence in Multiple Sclerosis.

INTRODUCTION: Communication difficulties are a common but under-recognized feature of multiple sclerosis (MS) and can affect quality of life, social participation, and engagement with health care. The extent to which communication functioning is associated with health literacy, medication beliefs, and adherence in MS remains poorly understood. METHODS: This cross-sectional study included 307 adults with MS recruited from Al-Bashir Hospital in Amman, Jordan. Participants completed validated Arabic versions of the Communication and Language Assessment Questionnaire for Multiple Sclerosis (CLAMS), the Health Literacy Survey-12 (HLS-Q12), the Beliefs about Medicines Questionnaire (BMQ), and the Medication Adherence Report Scale (MARS-5). Sociodemographic data were collected. Quantile regression analysis was used to examine associations between communication functioning and health literacy, medication beliefs, adherence, and sociodemographic factors. RESULTS: Communication difficulties were commonly reported, particularly problems with word finding, maintaining a train of thought, remembering information, and following conversations. Lower health literacy scores were significantly associated with higher CLAMS scores, indicating greater communication difficulties. Higher medication concern scores were also independently associated with poorer communication functioning. Lower educational attainment was linked to higher CLAMS scores. Medication adherence, necessity beliefs, age, sex, employment status, and income were not significantly associated with communication functioning in the adjusted model. CONCLUSION: Communication difficulties are prevalent among adults with MS and are closely linked to health literacy and medication-related concerns. Addressing these factors may support more effective communication, improved self-management, and better engagement with care.