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Aim: We aimed to assess adult primary health care (PHC) users' understanding of their medication information in a transitional South Eastern European population across seven domains.Methods: A cross-sectional study, carried out in Albania in 2018–19, included a representative sample of 1,553 PHC users aged ≥18 years (55% women; overall mean age: 54.6 ± 16.4 years; overall response rate: 94%). Participants were asked about their understanding of information they received from their respective family physicians about prescribed medicines in terms of factors like cost, dosage, and side-effects. Socio-demographic data were also gathered. Binary logistic regression was employed to assess the socio-demographic predictors of information about medication use and administration.Results: Across different aspects of use and administration, 21–60% of participants did not understand their medications. Less understanding of medication use was particularly high among the poor and those with low education and among urban residents, irrespective of socioeconomic status.Conclusion: This study provides important evidence about the level and socio-demographic determinants on understanding of information about medication use and administration among adult PHC users in a transitional former communist country in South Eastern Europe. Policymakers should be aware of the joint role and interplay between health literacy (demand side) and information provision (supply side), which both significantly influence the understanding of medication use by the general population.